Active NPI
Reena Abraham, DDS
- General Practice Dentistry
- Balch Springs, TX
National Provider Identifier
1336439892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 24859
- Practice address
- 12250 Lake June Rd
#101
Balch Springs, TX 75180-4716 - Phone
- (972) 557-2100
- NPI assigned
- Apr 18, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 24859 | TX | Primary |
Addresses
Primary practice location
12250 Lake June Rd
#101
Balch Springs, TX 75180-4716
Mailing address
312 Tallgrass LN
Plano, TX 75023-2379
Phone (979) 557-3509
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24859 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smile Workshop Balch Springs, PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Balch Springs, TX
- NPI 1821307000
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414368000000",
"number": "1336439892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 TALLGRASS LN",
"city": "PLANO",
"state": "TX",
"postal_code": "750232379",
"telephone_number": "979-557-3509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12250 LAKE JUNE RD",
"address_2": "#101",
"city": "BALCH SPRINGS",
"state": "TX",
"postal_code": "751804716",
"telephone_number": "972-557-2100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABRAHAM",
"first_name": "REENA",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-18",
"last_updated": "2014-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "24859",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Balch Springs, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.