Active NPI
Julee Tae, D.D.S.
- General Practice Dentistry
- Big Spring, TX
National Provider Identifier
1568874584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 29895
- Practice address
- 1915 S Gregg St
Big Spring, TX 79720-5434 - Phone
- (432) 264-0205
- NPI assigned
- May 25, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 29895 | TX | Primary |
Addresses
Primary practice location
1915 S Gregg St
Big Spring, TX 79720-5434
Mailing address
4508 Braddock Rd
Alexandria, VA 22312-1311
Phone (716) 343-1193
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150811003576 | TX | Order and Referring Only - Oral Surgery | 4880909530 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29895 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400976000000",
"number": "1568874584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4508 BRADDOCK RD",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223121311",
"telephone_number": "716-343-1193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1915 S GREGG ST",
"city": "BIG SPRING",
"state": "TX",
"postal_code": "797205434",
"telephone_number": "432-264-0205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAE",
"first_name": "JULEE",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-25",
"last_updated": "2014-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "29895",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Big Spring, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.