Active NPI
Mary Katherine Cleveland, DMD
- General Practice Dentistry
- Dallas, TX
National Provider Identifier
1467005686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 35234
- Practice address
- 9202 Elam Rd
Dallas, TX 75217-4151 - Phone
- (888) 682-7286
- NPI assigned
- Jul 17, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 35234 | TX | Primary |
Addresses
Primary practice location
9202 Elam Rd
Dallas, TX 75217-4151
Mailing address
7230 Meadow Lake Ave
Dallas, TX 75214-3526
Phone (256) 483-6763
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | https://bravodentaldallas.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35234 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563321600000",
"number": "1467005686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7230 MEADOW LAKE AVE",
"city": "DALLAS",
"state": "TX",
"postal_code": "752143526",
"telephone_number": "256-483-6763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9202 ELAM RD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752174151",
"telephone_number": "888-682-7286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEVELAND",
"first_name": "MARY",
"middle_name": "KATHERINE",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-17",
"last_updated": "2019-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "35234",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "https://bravodentaldallas.com",
"affiliation": "N",
"address_1": "9202 Elam Rd",
"city": "Dallas",
"state": "TX",
"country_code": "US",
"postal_code": "752174151",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.