Organization Active NPI

Dallas Dental Group, PLLC

  • Dentist
  • Dallas, TX
National Provider Identifier
1497100978
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DALLAS DENTAL GROUP, PLLC
Practice address
15123 Prestonwood Blvd
Suite 140
Dallas, TX 75248-4701
Phone
(214) 357-9066
NPI assigned
May 3, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2016

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

Authorized official

Name
Matthew Hale
Title
Authorized Representative
Phone
(214) 702-0721

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X TX Primary

Addresses

Primary practice location

15123 Prestonwood Blvd
Suite 140
Dallas, TX 75248-4701

Mailing address

2711 LBJ Fwy
Suite 122
Dallas, TX 75234-7315
Phone (214) 357-9066

National Provider Directory

National Provider Directory

Locations

15123 Prestonwood Blvd
Ste 140
Dallas, TX 75248
Phone (214) 357-9066

Practitioners & affiliated clinicians

Practitioners 1

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": "1462233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462233600000",
    "number": "1497100978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 LBJ FWY",
            "address_2": "SUITE 122",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752347315",
            "telephone_number": "214-357-9066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15123 PRESTONWOOD BLVD",
            "address_2": "SUITE 140",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752484701",
            "telephone_number": "214-357-9066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALLAS DENTAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-03",
        "last_updated": "2016-05-03",
        "status": "A",
        "authorized_official_last_name": "HALE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "214-702-0721"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 May 3, 2016; 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.