Breckenridge Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BRECKENRIDGE DENTAL PLLC

Practice address

111 S Miller St
Breckenridge, TX 76424-4355

Phone

(254) 559-2420

NPI assigned

Mar 8, 2021

Organization subpart

No

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

Authorized official

Name

Kamalpreet Shallu, DMD

Title

Owner/Dentist

Phone

(347) 759-2152

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Jong Lee, DDS

  • Dentist
  • Watauga, TX
  • NPI 1023222767
  NPD (past)

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

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615161600000",
    "number": "1588259840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S MILLER ST",
            "city": "BRECKENRIDGE",
            "state": "TX",
            "postal_code": "764244355",
            "telephone_number": "254-559-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S MILLER ST",
            "city": "BRECKENRIDGE",
            "state": "TX",
            "postal_code": "764244355",
            "telephone_number": "254-559-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRECKENRIDGE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-08",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A",
        "authorized_official_last_name": "SHALLU",
        "authorized_official_first_name": "KAMALPREET",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "347-759-2152",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bez Diagnostics
• Ramsie Rai Bradford, PHARMD
• Breath E-Z Health Care
• Breck Home Care, Inc.
• Breck Sleep Lab, Inc
• Breckenridge Family Clinic PA
• Breckenridge Isd
• Lisa Anne Brown, RN
• Shawnda Hennesay Camp, D.C.
• Jenifer Lynn Campbell, MPT

• Dental Clinic/Center in Breckenridge, TX
• Providers in Breckenridge, 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 Mar 8, 2021; 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.