Michael Chad Imboden, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21048 Issued in TX

Practice address

2301 Eldorado Pkwy
Suite 500
McKinney, TX 75070-4362

Phone

(972) 542-3005

Fax

(972) 542-6776

NPI assigned

Oct 5, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

State licenses

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326134545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5218 HAWKS NEST",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750705191",
            "telephone_number": "972-542-3005",
            "fax_number": "972-542-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 ELDORADO PKWY",
            "address_2": "SUITE 500",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750704362",
            "telephone_number": "972-542-3005",
            "fax_number": "972-542-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMBODEN",
        "first_name": "MICHAEL",
        "middle_name": "CHAD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in McKinney, TX
• Providers in McKinney, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.