Organization Active NPI

Standard Dental Alliance, PLLC.

  • Dentist
  • Terrell, TX
National Provider Identifier
1376838136
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
STANDARD DENTAL ALLIANCE, PLLC.
Practice address
1405 W Moore Ave
Terrell, TX 75160-2303
Phone
(972) 563-8383
NPI assigned
Jun 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Authorized official

Name
Dr. Michael G. Heffelfinger, DDSNPI 1295055739
Title
Dentist
Phone
(972) 563-8383

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1405 W Moore Ave
Terrell, TX 75160-2303

Mailing address

1405 W Moore Ave
Terrell, TX 75160-2303
Phone (972) 563-8383

Other identifiers 1

IdentifierTypeStateIssuer
2821993MedicaidTX

Other names 1

  • Legacy Dental Doing business as

National Provider Directory

National Provider Directory

Locations

1405 W Moore Ave
Terrell, TX 75160
Phone (972) 563-8383

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": "1307577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1376838136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 W MOORE AVE",
            "city": "TERRELL",
            "state": "TX",
            "postal_code": "751602303",
            "telephone_number": "972-563-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 W MOORE AVE",
            "city": "TERRELL",
            "state": "TX",
            "postal_code": "751602303",
            "telephone_number": "972-563-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANDARD DENTAL ALLIANCE, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-09",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "HEFFELFINGER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "972-563-8383",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2821993",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Terrell, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.