NPIMap

Organization Active NPI

Custom Dental of McKinney, PLLC

  • Dentist
  • McKinney, TX
National Provider Identifier
1487055273
Registry record updated Sep 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30322 Issued in TX
Legal business name
CUSTOM DENTAL OF MCKINNEY, PLLC
Practice address
6351 S Custer Rd
McKinney, TX 75070
Phone
(214) 310-2822
NPI assigned
Sep 11, 2014
Last updated
Sep 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2014

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

Authorized official

Name
Bryce Michael Gates, DDSNPI 1396157806
Title
Doctor
Phone
(214) 310-2822

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 30322 TX Primary

Addresses

Primary practice location

6351 S Custer Rd
McKinney, TX 75070

Mailing address

6351 S Custer Rd
McKinney, TX 75070
Phone (214) 310-2822

National Provider Directory

National Provider Directory

Locations

6351 S Custer Rd
McKinney, TX 75070
Phone (214) 310-2822

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410393600000",
    "number": "1487055273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6351 S CUSTER RD",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "75070",
            "telephone_number": "214-310-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6351 S CUSTER RD",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "75070",
            "telephone_number": "214-310-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM DENTAL OF MCKINNEY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-11",
        "last_updated": "2014-09-11",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "BRYCE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "214-310-2822",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "30322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.