NPIMap

Organization Active NPI

Crystal Creek Dental

  • General Practice Dentistry
  • Plano, TX
National Provider Identifier
1275741126
Registry record updated Aug 22, 2020
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21736 Issued in TX
Legal business name
CRYSTAL CREEK DENTAL
Practice address
4637 Hedgcoxe Rd
Suite 112
Plano, TX 75024-3962
Phone
(972) 377-8866
Fax
(972) 377-8870
NPI assigned
May 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tuan Nguyen
Title
President
Phone
(972) 377-8866

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 21736 TX Primary

Addresses

Primary practice location

4637 Hedgcoxe Rd
Suite 112
Plano, TX 75024-3962

Mailing address

4637 Hedgcoxe Rd
Suite 112
Plano, TX 75024-3962
Phone (972) 377-8866

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275741126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4637 HEDGCOXE RD",
            "address_2": "SUITE 112",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243962",
            "telephone_number": "972-377-8866",
            "fax_number": "972-377-8870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4637 HEDGCOXE RD",
            "address_2": "SUITE 112",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243962",
            "telephone_number": "972-377-8866",
            "fax_number": "972-377-8870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL CREEK DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "TUAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-377-8866"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.