NPIMap

Organization Active NPI

Prime Dental

  • General Practice Dentistry
  • Grand Prairie, TX
National Provider Identifier
1417545880
Registry record updated Jan 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PRIME DENTAL
Practice address
2580 W Camp Wisdom Rd Ste 300
Grand Prairie, TX 75052-3091
Phone
(972) 408-0408
NPI assigned
Jan 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2021

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

Authorized official

Name
Nilam Patel, DDS
Title
Owner
Phone
(972) 408-0408

Specialties & licenses 1

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

Addresses

Primary practice location

2580 W Camp Wisdom Rd Ste 300
Grand Prairie, TX 75052-3091

Mailing address

4116 Saguaro LN
Irving, TX 75063-1242
Phone (267) 495-7393

National Provider Directory

National Provider Directory
Tax ID family
214 Dental PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1609459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609459200000",
    "number": "1417545880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4116 SAGUARO LN",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750631242",
            "telephone_number": "267-495-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 W CAMP WISDOM RD STE 300",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750523091",
            "telephone_number": "972-408-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-01",
        "last_updated": "2021-01-01",
        "certification_date": "2021-01-01",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "NILAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-408-0408",
        "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 Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2021; 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.