Charles Douglas Palmer Jr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19327 Issued in TX

Practice address

608 Grapevine Hwy
Hurst, TX 76054-2775

Phone

(817) 656-2202

Fax

(817) 656-1904

NPI assigned

Jun 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427085265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 GLENSHIRE DR",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750283172",
            "telephone_number": "817-854-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 GRAPEVINE HWY",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760542775",
            "telephone_number": "817-656-2202",
            "fax_number": "817-656-1904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "CHARLES",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "19327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Precious Osuoha, OTR
• Meriden Overall
• Vivienne Owusu-Appiah, NP
• Ashlea Michele Palafox, LPC, C. HYP, RTTP
• Daniela Andrea Palma
• Shakeitha Lynette Papillion, OTR
• Darshika Parekh
• Shane Everett Parker, D.C.
• Vanessa Jane Parkinson
• Bhooma Parthasarathy, OTR

• General Practice Dentistry in Hurst, TX
• Providers in Hurst, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.