NPIMap

Organization Active NPI

Comfort Dental Clay Mathis, PLLC

  • General Practice Dentistry
  • Mesquite, TX
National Provider Identifier
1326276205
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
24312 Issued in TX
Legal business name
COMFORT DENTAL CLAY MATHIS, PLLC
Practice address
540 Clay Mathis Rd
110
Mesquite, TX 75181-1167
Phone
(972) 222-5313
NPI assigned
Jun 30, 2009
Last updated
Jun 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Authorized official

Name
Dr. Jeremy Bullock, DMD
Title
Owner/Dentist
Phone
(972) 222-5313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 24312 TX Primary

Addresses

Primary practice location

540 Clay Mathis Rd
110
Mesquite, TX 75181-1167

Mailing address

540 Clay Mathis Rd
110
Mesquite, TX 75181-1167
Phone (972) 222-5313

National Provider Directory

National Provider Directory

Locations

540 Clay Mathis Rd
Ste 110
Mesquite, TX 75181
Phone (972) 222-5313

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246320000000",
    "number": "1326276205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 CLAY MATHIS RD",
            "address_2": "110",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751811167",
            "telephone_number": "972-222-5313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 CLAY MATHIS RD",
            "address_2": "110",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751811167",
            "telephone_number": "972-222-5313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORT DENTAL CLAY MATHIS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-30",
        "last_updated": "2009-06-30",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "972-222-5313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "24312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; 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.