Champion Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

CHAMPION DENTAL

Doing business as

Champion Dental

Practice address

2936 Valley View LN
Farmers Branch, TX 75234-4929

Phone

(214) 945-7334

NPI assigned

Oct 16, 2019

Organization subpart

No

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

Authorized official

Name

Chad Hendricks

Title

Credentialing Manager

Phone

(612) 859-0444

Specialties & licenses 1

Addresses

Other names 1

• Champion Dental Doing business as

Locations

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

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571184000000",
    "number": "1528600988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2936 VALLEY VIEW LN",
            "city": "FARMERS BRANCH",
            "state": "TX",
            "postal_code": "752344929",
            "telephone_number": "214-945-7334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2936 VALLEY VIEW LN",
            "city": "FARMERS BRANCH",
            "state": "TX",
            "postal_code": "752344929",
            "telephone_number": "214-945-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPION DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-16",
        "last_updated": "2019-10-16",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "612-859-0444"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Champion Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Reynaldo Castillo
• Jose Adrian Cavazos
• Nancy Cawthon
• Anita Cepeda, LPC
• Sara Kay Chadwick
• Deanna Chandler
• Sara Chapman
• Stephanie Yachen Chen, O.D.
• Brandon Childress
• Jaelynn S Choi

• Dental Clinic/Center in Farmers Branch, TX
• Providers in Farmers Branch, 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 Oct 16, 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.

Verify at the official NPI Registry.