Active NPI
Folger Bryant Vallette III, D.D.S.
- Dentist
- Canyon, TX
National Provider Identifier
1396950697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 13230
- Practice address
- 2000 4TH Ave
Canyon, TX 79015-4026 - Phone
- (806) 655-2191
- Fax
- (806) 655-2192
- NPI assigned
- May 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 13230 | TX | Primary |
Addresses
Primary practice location
2000 4TH Ave
Canyon, TX 79015-4026
Mailing address
2000 4TH Ave
Canyon, TX 79015-4026
Phone (806) 655-2191
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 |
|---|---|---|---|---|
| I20190522000732 | TX | Order and Referring Only - Dentist | 2163765702 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13230 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475452800000",
"number": "1396950697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 4TH AVE",
"city": "CANYON",
"state": "TX",
"postal_code": "790154026",
"telephone_number": "806-655-2191",
"fax_number": "806-655-2192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 4TH AVE",
"city": "CANYON",
"state": "TX",
"postal_code": "790154026",
"telephone_number": "806-655-2191",
"fax_number": "806-655-2192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALLETTE",
"first_name": "FOLGER",
"middle_name": "BRYANT",
"name_suffix": "III",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-11",
"last_updated": "2016-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "13230",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canyon, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; 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.