Dental Provider Resources 2, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DENTAL PROVIDER RESOURCES 2, PLLC

Doing business as

Paloma Creek Dental

Practice address

26735 US Highway 380 E
Ste 105
Aubrey, TX 76227-8210

Phone

(972) 347-1090

Fax

(972) 347-1021

NPI assigned

May 21, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Jared Bruggeman

Title

DDS

Phone

(817) 328-1650

Specialties & licenses 1

Addresses

Other names 1

• Paloma Creek Dental Doing business as

Locations

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337558400000",
    "number": "1366702607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 TEXAN TRL",
            "address_2": "SUITE 229",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513776",
            "telephone_number": "817-328-6150",
            "fax_number": "866-882-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26735 US HIGHWAY 380 E",
            "address_2": "STE 105",
            "city": "AUBREY",
            "state": "TX",
            "postal_code": "762278210",
            "telephone_number": "972-347-1090",
            "fax_number": "972-347-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROVIDER RESOURCES 2, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-21",
        "last_updated": "2012-05-21",
        "status": "A",
        "authorized_official_last_name": "BRUGGEMAN",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "817-328-1650",
        "authorized_official_name_prefix": "Dr."
    },
    "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": "Paloma Creek Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Aubrey, TX
• Providers in Aubrey, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2012; 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.