NPIMap

Organization Active NPI

Edge-MD Dentacare, PLLC

  • Family Medicine Physician
  • Arlington, TX
National Provider Identifier
1275938425
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N0318 Issued in TX
Legal business name
EDGE-MD DENTACARE, PLLC
Practice address
2440 S Collins St
Suite 140
Arlington, TX 76014-1239
Phone
(817) 459-2501
Fax
(817) 459-2341
NPI assigned
Oct 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Authorized official

Name
Nathan Nguyen, MD
Title
MD/Owner
Phone
(979) 532-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X N0318 TX Primary

Addresses

Primary practice location

2440 S Collins St
Suite 140
Arlington, TX 76014-1239

Mailing address

2022 Regional Medical Dr
Suite 1315
Wharton, TX 77488-7231
Phone (979) 532-2000

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421107200000",
    "number": "1275938425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2022 REGIONAL MEDICAL DR",
            "address_2": "SUITE 1315",
            "city": "WHARTON",
            "state": "TX",
            "postal_code": "774887231",
            "telephone_number": "979-532-2000",
            "fax_number": "979-532-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 S COLLINS ST",
            "address_2": "SUITE 140",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760141239",
            "telephone_number": "817-459-2501",
            "fax_number": "817-459-2341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGE-MD DENTACARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-30",
        "last_updated": "2015-01-13",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "979-532-2000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N0318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.