Individual provider Active NPI

Danny Warren Addington, DDS

  • General Practice Dentistry
  • Atlanta, TX
National Provider Identifier
1417050667
Registry record updated Mar 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14383 Issued in TX
Practice address
307 East Hiram
Atlanta, TX 75551
Phone
(903) 796-2111
Fax
(903) 796-5401
NPI assigned
Sep 6, 2006
Last updated
Mar 31, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 14383 TX Primary

Addresses

Primary practice location

307 East Hiram
Atlanta, TX 75551

Mailing address

307 East Hiram
Atlanta, TX 75551
Phone (903) 796-2111

Other identifiers 1

IdentifierTypeStateIssuer
090292602MedicaidTX

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161206002373 TX Order and Referring Only - DentistPractitioner - Dentist 0941580005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14383TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1417050667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 EAST HIRAM",
            "city": "ATLANTA",
            "state": "TX",
            "postal_code": "75551",
            "telephone_number": "903-796-2111",
            "fax_number": "903-796-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 EAST HIRAM",
            "city": "ATLANTA",
            "state": "TX",
            "postal_code": "75551",
            "telephone_number": "903-796-2111",
            "fax_number": "903-796-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDINGTON",
        "first_name": "DANNY",
        "middle_name": "WARREN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "14383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090292602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, TX

Sources for this page

Verify at the official NPI Registry.