NPIMap

Organization Active NPI

Premier Dental Associates PLLC

  • General Practice Dentistry
  • Sachse, TX
National Provider Identifier
1538644760
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PREMIER DENTAL ASSOCIATES PLLC
Practice address
6504 Hwy 78 Ste 146-B
Sachse, TX 75048
Phone
(972) 968-8283
NPI assigned
Oct 3, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Authorized official

Name
Dr. Aby A Jacob, DMDNPI 1518089432
Title
Member
Phone
(972) 968-8283

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

6504 Hwy 78 Ste 146-B
Sachse, TX 75048

Mailing address

6504 Hwy 78 Ste 146-B
Sachse, TX 75048
Phone (972) 968-8283

National Provider Directory

National Provider Directory

Locations

6504 Highway 78
Ste 146B
Sachse, TX 75048
Phone (972) 968-8283

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": "1538524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538524800000",
    "number": "1538644760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6504 HWY 78 STE 146-B",
            "city": "SACHSE",
            "state": "TX",
            "postal_code": "75048",
            "telephone_number": "972-968-8283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6504 HWY 78 STE 146-B",
            "city": "SACHSE",
            "state": "TX",
            "postal_code": "75048",
            "telephone_number": "972-968-8283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DENTAL ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-03",
        "last_updated": "2018-10-03",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "ABY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "972-968-8283",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sachse, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; 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.