Walnut Grove Dental, PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

21256 Issued in TX

Legal business name

WALNUT GROVE DENTAL, PC

Practice address

403 W Wheatland Rd
Duncanville, TX 75116-4619

Phone

(972) 298-4191

NPI assigned

Apr 2, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Alan S Martin, D.D.S

Title

Director

Phone

(972) 298-4191

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207094400000",
    "number": "1487826194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 W WHEATLAND RD",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751164619",
            "telephone_number": "972-298-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W WHEATLAND RD",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751164619",
            "telephone_number": "972-298-4191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT GROVE DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-04-02",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "972-298-4191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "21256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Duncanville, TX
• Providers in Duncanville, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.