Active NPI
Amber Vickers Guirguis, D.D.S.
- General Practice Dentistry
- Dallas, TX
National Provider Identifier
1376854760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 25678
- Practice address
- 16631 Coit Rd Ste 114
Dallas, TX 75248-1795 - Phone
- (214) 484-5978
- NPI assigned
- Jun 30, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 25678 | TX | Primary |
Addresses
Primary practice location
16631 Coit Rd Ste 114
Dallas, TX 75248-1795
Mailing address
4109 High Star LN
Dallas, TX 75287-6737
Phone (614) 352-8448
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151210000639 | TX | Order and Referring Only - Dentist | 8426359720 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25678 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Promise Dental PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dental Clinic/Center
- Dallas, TX
- NPI 1184323446
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447632000000",
"number": "1376854760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4109 HIGH STAR LN",
"city": "DALLAS",
"state": "TX",
"postal_code": "752876737",
"telephone_number": "614-352-8448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16631 COIT RD STE 114",
"city": "DALLAS",
"state": "TX",
"postal_code": "752481795",
"telephone_number": "214-484-5978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUIRGUIS",
"first_name": "AMBER",
"middle_name": "VICKERS",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-30",
"last_updated": "2015-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "25678",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.