NPIMap

Organization Active NPI

Ideal Dental of Euless

  • General Practice Dentistry
  • Euless, TX
National Provider Identifier
1376837252
Registry record updated Jun 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22290 Issued in TX
Legal business name
IDEAL DENTAL OF EULESS
Practice address
3010 State Highway 121
300
Euless, TX 76039-5823
Phone
(817) 571-3368
NPI assigned
Jun 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2011

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

Authorized official

Name
Ms. Carol L Cantu
Title
Insurance Specialist
Phone
(817) 571-3368

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 22290 TX Primary

Addresses

Primary practice location

3010 State Highway 121
300
Euless, TX 76039-5823

Mailing address

3010 State Highway 121
300
Euless, TX 76039-5823
Phone (817) 571-3368

Other names 1

  • Parkside Dental Doing business as

National Provider Directory

National Provider Directory

Locations

3010 State Highway 121
Ste 300
Euless, TX 76039
Phone (469) 858-1890

Practitioners & affiliated clinicians

Practitioners 2

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": "1307491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307491200000",
    "number": "1376837252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 STATE HIGHWAY 121",
            "address_2": "300",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760395823",
            "telephone_number": "817-571-3368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 STATE HIGHWAY 121",
            "address_2": "300",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760395823",
            "telephone_number": "817-571-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL DENTAL OF EULESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-08",
        "last_updated": "2011-06-08",
        "status": "A",
        "authorized_official_last_name": "CANTU",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "INSURANCE SPECIALIST",
        "authorized_official_telephone_number": "817-571-3368",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parkside Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Euless, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; 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.