Charles John Patterson Jr., D.D.S.. M.S.

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

17108 Issued in TX

Practice address

4514 Cole Ave
Suite 920
Dallas, TX 75205-5412

Phone

(214) 526-3434

Fax

(214) 526-3439

NPI assigned

Jun 26, 2006

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

Other names 1

• Dr. Charles John Patterson Jr. Other name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336176361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4514 COLE AVE",
            "address_2": "SUITE 920",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752055412",
            "telephone_number": "214-526-3434",
            "fax_number": "214-526-3439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4514 COLE AVE",
            "address_2": "SUITE 920",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752055412",
            "telephone_number": "214-526-3434",
            "fax_number": "214-526-3439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "CHARLES",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.. M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "TX",
            "license": "17108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLES",
            "last_name": "PATTERSON",
            "middle_name": "JOHN",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "D.D.S., M.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Pattern Shift Counseling, PLLC
• Abigail Marie Patterson, MD
• Amanda Patterson, APRN
• Annette Rochelle Patterson, M.S., C.G.C.
• Briona Patterson, RN
• Cooper Michael Patterson, CRNA
• Debra Patterson, M.D.
• Ditallianna Patterson, MSW, LCSW
• Dorothy Patterson, MD
• Emily Patterson, M.ED, RD, CSP, LD

• Prosthodontics in Dallas, TX
• Providers in Dallas, TX by specialty
• Prosthodontics 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.