NPIMap

Organization Active NPI

Legacy Dental of Beaumont PLLC

  • General Practice Dentistry
  • Beaumont, TX
National Provider Identifier
1407319213
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LEGACY DENTAL OF BEAUMONT PLLC
Practice address
6480 Eastex Fwy Ste a
Beaumont, TX 77708-4336
Phone
(832) 725-9895
NPI assigned
Apr 9, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Authorized official

Name
Dr. Sohail Dar, DDS
Title
Owner
Phone
(409) 241-8383

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

6480 Eastex Fwy Ste a
Beaumont, TX 77708-4336

Mailing address

6480 Eastex Fwy Ste a
Beaumont, TX 77708-4336
Phone (409) 241-8383

National Provider Directory

National Provider Directory

Locations

6480 Eastex Fwy
Ste A
Beaumont, TX 77708
Phone (409) 241-8383

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598313600000",
    "number": "1407319213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6480 EASTEX FWY STE A",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777084336",
            "telephone_number": "409-241-8383",
            "fax_number": "409-241-8384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6480 EASTEX FWY STE A",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777084336",
            "telephone_number": "832-725-9895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY DENTAL OF BEAUMONT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-09",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "DAR",
        "authorized_official_first_name": "SOHAIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-241-8383",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; 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.