Individual provider Active NPI

Toya M Dudley, DDS

  • General Practice Dentistry
  • Denton, TX
National Provider Identifier
1376844084
Registry record updated Aug 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
29454 Issued in TX
Practice address
2548 Lillian Miller Pkwy
Suite 120
Denton, TX 76210-7212
Phone
(940) 300-6663
Fax
(972) 947-3957
NPI assigned
Nov 11, 2010
Last updated
Aug 14, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 29454 TX Primary

Addresses

Primary practice location

2548 Lillian Miller Pkwy
Suite 120
Denton, TX 76210-7212

Mailing address

2548 Lillian Miller Pkwy
Suite 120
Denton, TX 76210-7212
Phone (940) 300-6663

Other identifiers 1

IdentifierTypeStateIssuer
6121OtherLALOUISIANA STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170531000777 TX Order and Referring Only - DentistPractitioner - Dentist 6305113077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29454TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Abc Dental Group PLLC Past Accepting new patients
Community Health Service Agency, Inc. General Practice Past Accepting new patients
Lakeland Healthcare Management Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1289433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407974400000",
    "number": "1376844084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2548 LILLIAN MILLER PKWY",
            "address_2": "SUITE 120",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762107212",
            "telephone_number": "940-300-6663",
            "fax_number": "972-947-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2548 LILLIAN MILLER PKWY",
            "address_2": "SUITE 120",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762107212",
            "telephone_number": "940-300-6663",
            "fax_number": "972-947-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "TOYA",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-11",
        "last_updated": "2014-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "29454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOUISIANA STATE LICENSE",
            "identifier": "6121",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

Verify at the official NPI Registry.