NPIMap

Organization Active NPI

Rockwall Modern Dentistry and Orthodontics, PC

  • General Practice Dentistry
  • Rockwall, TX
National Provider Identifier
1447519624
Registry record updated Jan 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12406 Issued in TX
Legal business name
ROCKWALL MODERN DENTISTRY AND ORTHODONTICS, PC
Practice address
1039 E Interstate 30
Suite 107
Rockwall, TX 75087-4899
Phone
(972) 722-4914
Fax
(972) 722-5030
NPI assigned
May 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2014

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

Authorized official

Name
Dr. John Barnes
Title
Owner-DDS
Phone
(972) 722-4914

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 12406 TX Primary

Addresses

Primary practice location

1039 E Interstate 30
Suite 107
Rockwall, TX 75087-4899

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8890

Other names 1

  • Rockwall Modern Dentistry and Orthodontics Doing business as

National Provider Directory

National Provider Directory

Locations

1039 E Interstate 30
Ste 107
Rockwall, TX 75087
Phone (972) 722-4914

Practitioners & affiliated clinicians

Practitioners 6

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": "1336521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388620800000",
    "number": "1447519624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "714-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 E INTERSTATE 30",
            "address_2": "SUITE 107",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750874899",
            "telephone_number": "972-722-4914",
            "fax_number": "972-722-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKWALL MODERN DENTISTRY AND ORTHODONTICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-09",
        "last_updated": "2014-01-02",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER-DDS",
        "authorized_official_telephone_number": "972-722-4914",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "12406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rockwall Modern Dentistry and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockwall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; 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.