Organization Active NPI

Rice Road Dental Associates, P.a.

  • Dentist
  • Tyler, TX
National Provider Identifier
1275955486
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8662 Issued in TX
Legal business name
RICE ROAD DENTAL ASSOCIATES, P.A.
Practice address
5613 S Donnybrook Ave
Tyler, TX 75703
Phone
(903) 561-3411
Fax
(903) 581-7014
NPI assigned
Jan 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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

Authorized official

Name
Meleaha T. Morton
Title
Office Manager
Phone
(903) 561-3411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 8662 TX Primary

Addresses

Primary practice location

5613 S Donnybrook Ave
Tyler, TX 75703

Mailing address

5613 S Donnybrook Ave
Tyler, TX 75703
Phone (903) 561-3411

National Provider Directory

National Provider Directory

Locations

5613 Donnybrook Ave
Tyler, TX 75703
Phone (903) 561-3411

3930 Old Bullard Rd
Tyler, TX 75701
Phone (903) 561-6021

NPI Registry JSON

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

{
    "created_epoch": "1389139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576454400000",
    "number": "1275955486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5613 S DONNYBROOK AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75703",
            "telephone_number": "903-561-3411",
            "fax_number": "903-581-7014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5613 S DONNYBROOK AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75703",
            "telephone_number": "903-561-3411",
            "fax_number": "903-581-7014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICE ROAD DENTAL ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-08",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A",
        "authorized_official_last_name": "MORTON",
        "authorized_official_first_name": "MELEAHA",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "903-561-3411"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "8662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; 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.