Crockett Dental Care PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

17145 Issued in TX

Legal business name

CROCKETT DENTAL CARE PLLC

Practice address

1050 E Loop 304 Ste 120
Crockett, TX 75835-1800

Phone

(936) 544-3554

NPI assigned

Mar 16, 2016

Last updated

Mar 16, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Joseph Henderson Holcomb, DDSNPI 1942318035

Title

President

Phone

(936) 544-3554

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joseph Henderson Holcomb, DDS

  • General Practice Dentistry
  • Crockett, TX
  • NPI 1942318035
  NPD (past) Authorized official

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458086400000",
    "number": "1407217664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 E LOOP 304 STE 120",
            "city": "CROCKETT",
            "state": "TX",
            "postal_code": "758351800",
            "telephone_number": "936-544-3554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 E LOOP 304 STE 120",
            "city": "CROCKETT",
            "state": "TX",
            "postal_code": "758351800",
            "telephone_number": "936-544-3554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROCKETT DENTAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-16",
        "last_updated": "2016-03-16",
        "status": "A",
        "authorized_official_last_name": "HOLCOMB",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "HENDERSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "936-544-3554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "8092",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "17145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "1942318035",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "1598873614",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coryell County Memorial Hospital Authority (Avir at Whitehall)
• Coryell County Memorial Hospital Authority (Community Care Center of Crockett)
• Coryell County Memorial Hospital Authority (Avir at Crockett)
• Crockett Clinic LLP
• Crockett Counseling Center , LLC
• Crockett Health Care Associates, Inc. (Houston County Nursing Home)
• Crockett Independent School District
• Crockett Medical Center, LLC (Crockett Medical Center Clinic)
• Crockett Senior Care LLC (Community Care Center of Crockett)
• Crockett SNF LLC (Community Care Center of Crockett)

• Dentist in Crockett, TX
• Providers in Crockett, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; 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.