Organization Active NPI

Dental Health Associates of Texas, PC

  • General Practice Dentistry
  • McKinney, TX
National Provider Identifier
1609089937
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15772 Issued in TX
Legal business name
DENTAL HEALTH ASSOCIATES OF TEXAS, PC
Practice address
1760 W Virginia St
Ste 100
McKinney, TX 75069-7864
Phone
(972) 547-6453
Fax
(972) 542-0121
NPI assigned
May 7, 2007
Last updated
Jul 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Authorized official

Name
Hannah Fish
Title
Credentialing Manager
Phone
(217) 540-5699

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 20135 TX
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 20748 TX
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 16034 TX
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 15772 TX Primary

Addresses

Primary practice location

1760 W Virginia St
Ste 100
McKinney, TX 75069-7864

Mailing address

1760 W Virginia St
Ste 100
McKinney, TX 75069-7864
Phone (972) 547-6453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260519002468 TX Part B Supplier - Clinic/Group Practice 8820455009 Receives reassigned benefits from 1 practitioner
Practice locations: McKinney, TX

National Provider Directory

National Provider Directory

Locations

1760 W Virginia St
Ste 100
McKinney, TX 75069
Phone (972) 547-6453

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1609089937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 W VIRGINIA ST",
            "address_2": "STE 100",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750697864",
            "telephone_number": "972-547-6453",
            "fax_number": "972-542-0121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 W VIRGINIA ST",
            "address_2": "STE 100",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750697864",
            "telephone_number": "972-547-6453",
            "fax_number": "972-542-0121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL HEALTH ASSOCIATES OF TEXAS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "FISH",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "217-540-5699"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20135",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20748",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "16034",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "15772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.