Edge-MD Dentacare, PLLC

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

Last updated

Jan 13, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nathan Nguyen, MDNPI 1821256942

Title

MD/Owner

Phone

(979) 532-2000

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nathan Phuckhac Nguyen, M.D,

  • Family Medicine Physician
  • Wharton, TX
  • NPI 1821256942
  Authorized official Same address or phone

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": []
}

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• Family Medicine Physician in Arlington, TX
• Providers in Arlington, TX by specialty
• Family Medicine Physician in Texas

• 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.