Edgemere Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

EDGEMERE DENTAL PLLC

Practice address

12371 Edgemere Blvd Ste 206
El Paso, TX 79938-4878

Phone

(915) 921-6200

NPI assigned

Apr 9, 2021

Organization subpart

No

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

Authorized official

Name

Del Grant Greenhalgh, DMD

Title

Owner

Phone

(915) 921-6200

Specialties & licenses 1

Addresses

Other names 1

• Edgemere Dental Doing business as

Locations

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

{
    "created_epoch": "1617926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617926400000",
    "number": "1366022774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10510 MONTWOOD DR STE B",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799352717",
            "telephone_number": "352-443-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12371 EDGEMERE BLVD STE 206",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799384878",
            "telephone_number": "915-921-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEMERE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-09",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A",
        "authorized_official_last_name": "GREENHALGH",
        "authorized_official_first_name": "DEL",
        "authorized_official_middle_name": "GRANT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "915-921-6200",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edgemere Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in El Paso, TX
• Providers in El Paso, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; 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.