NPIMap

Organization Active NPI

Fairway Drive Dentistry PLLC

  • General Practice Dentistry
  • Alvin, TX
National Provider Identifier
1336764000
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FAIRWAY DRIVE DENTISTRY PLLC
Practice address
1701 Fairway Dr Ste 20
Alvin, TX 77511-4678
Phone
(281) 331-0020
Fax
(281) 585-0505
NPI assigned
Jun 9, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2020

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

Authorized official

Name
Faith Gaskins
Title
Director of Credentialing
Phone
(972) 869-3789

Specialties & licenses 1

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

Addresses

Primary practice location

1701 Fairway Dr Ste 20
Alvin, TX 77511-4678

Mailing address

1701 Fairway Dr Ste 20
Alvin, TX 77511-4678
Phone (281) 331-0020

Other names 1

  • Alvin Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

1701 Fairway Dr
Ste 20
Alvin, TX 77511
Phone (281) 331-0020

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591660800000",
    "number": "1336764000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 FAIRWAY DR STE 20",
            "city": "ALVIN",
            "state": "TX",
            "postal_code": "775114678",
            "telephone_number": "281-331-0020",
            "fax_number": "281-585-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 FAIRWAY DR STE 20",
            "city": "ALVIN",
            "state": "TX",
            "postal_code": "775114678",
            "telephone_number": "281-331-0020",
            "fax_number": "281-585-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRWAY DRIVE DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-09",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A",
        "authorized_official_last_name": "GASKINS",
        "authorized_official_first_name": "FAITH",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alvin Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alvin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; 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.