NPIMap

Organization Active NPI

Mabry and Coniglio Dentistry

  • Dental Clinic/Center
  • Southlake, TX
National Provider Identifier
1346757960
Registry record updated Jan 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
10892 Issued in TX
Legal business name
MABRY AND CONIGLIO DENTISTRY
Practice address
271 E Southlake Blvd Ste 100
Southlake, TX 76092-6272
Phone
(817) 329-6677
Fax
(817) 488-4995
NPI assigned
Jan 4, 2018
Last updated
Jan 4, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2018

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

Authorized official

Name
Melinda Britton
Title
Treatment Coordinator
Phone
(817) 329-6677

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 10892 TX Primary
Dental Clinic/Center 261QD0000X 24577 TX

Addresses

Primary practice location

271 E Southlake Blvd Ste 100
Southlake, TX 76092-6272

Mailing address

271 E Southlake Blvd Ste 100
Southlake, TX 76092-6272
Phone (817) 329-6677

Other identifiers 2

IdentifierTypeStateIssuer
1639307051OtherTXDENTAL
1568500197OtherTXDENTAL

Other names 1

  • Michael Mabry DDS PC Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515024000000",
    "number": "1346757960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 E SOUTHLAKE BLVD STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926272",
            "telephone_number": "817-329-6677",
            "fax_number": "817-488-4995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 E SOUTHLAKE BLVD STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926272",
            "telephone_number": "817-329-6677",
            "fax_number": "817-488-4995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MABRY AND CONIGLIO DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-04",
        "last_updated": "2018-01-04",
        "status": "A",
        "authorized_official_last_name": "BRITTON",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_title_or_position": "TREATMENT COORDINATOR",
        "authorized_official_telephone_number": "817-329-6677"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "10892",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "24577",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "1639307051",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "1568500197",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael Mabry DDS PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; 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.