Paul J Ezzo, D.D.S., PH.D

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

17188 Issued in TX

Practice address

2213 McDermott Rd
Plano, TX 75025-4613

Phone

(972) 527-4867

Fax

(972) 665-1818

NPI assigned

May 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1275749442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 MCDERMOTT RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750254613",
            "telephone_number": "729-527-4867",
            "fax_number": "972-665-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 MCDERMOTT RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750254613",
            "telephone_number": "972-527-4867",
            "fax_number": "972-665-1818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "136 old blvd suite 200",
            "address_purpose": "LOCATION",
            "city": "argyle",
            "state": "TX",
            "postal_code": "762267502",
            "country_code": "US",
            "telephone_number": "972-468-1191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EZZO",
        "first_name": "PAUL",
        "middle_name": "J",
        "credential": "D.D.S., PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2022-09-23",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "17188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eyes on Preston Park PLLC
• Ez DME, LLC
• Ez Mobile Diagnostic Services Management Inc
• Ez Sleep Medical Clinic Corporation
• Chidinma Paschaline Ezenwa
• F. Alan Barber, M.D., Facs, P.a.
• F. J. Slater Leasing Co
• Olayinka Olapeju Fabamise
• Jessica Faber, M.A., LPA
• Facial and Skin Surgery Center PA

• Periodontics in Plano, TX
• Providers in Plano, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.