Active NPI
Bernard Anthony Avendanio, D.D.S.
- General Practice Dentistry
- Dallas, TX
National Provider Identifier
1396753570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 18840
- Practice address
- 2929 Carlisle St Ste 100
Dallas, TX 75204-4043 - Phone
- (214) 953-0906
- Fax
- (214) 953-0106
- NPI assigned
- Aug 4, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 | 18840 | TX | Primary |
Addresses
Primary practice location
2929 Carlisle St Ste 100
Dallas, TX 75204-4043
Mailing address
2929 Carlisle St Ste 100
Dallas, TX 75204-4043
Phone (214) 953-0906
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18840 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Turtle Creek Da, 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, 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": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396753570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2929 CARLISLE ST STE 100",
"city": "DALLAS",
"state": "TX",
"postal_code": "752044043",
"telephone_number": "214-953-0906",
"fax_number": "214-953-0106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2929 CARLISLE ST STE 100",
"city": "DALLAS",
"state": "TX",
"postal_code": "752044043",
"telephone_number": "214-953-0906",
"fax_number": "214-953-0106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVENDANIO",
"first_name": "BERNARD",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "18840",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.