Organization Active NPI

Natural Dentistry of North Texas, PLLC

  • Dental Clinic/Center
  • Mesquite, TX
National Provider Identifier
1609264670
Registry record updated Dec 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
12609 Issued in TX
Legal business name
NATURAL DENTISTRY OF NORTH TEXAS, PLLC
Practice address
1645 N Town East Blvd Ste 532
Mesquite, TX 75150-4147
Phone
(214) 616-7161
Fax
(972) 681-5986
NPI assigned
Dec 29, 2014
Last updated
Dec 29, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2014

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

Authorized official

Name
Dr. Gottfred P Olsen, DDS
Title
President
Phone
(214) 616-7161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 12609 TX Primary

Addresses

Primary practice location

1645 N Town East Blvd Ste 532
Mesquite, TX 75150-4147

Mailing address

1645 N Town East Blvd Ste 532
Mesquite, TX 75150-4147
Phone (214) 616-7161

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1419811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419811200000",
    "number": "1609264670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 N TOWN EAST BLVD STE 532",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751504147",
            "telephone_number": "214-616-7161",
            "fax_number": "972-681-5986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 N TOWN EAST BLVD STE 532",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751504147",
            "telephone_number": "214-616-7161",
            "fax_number": "972-681-5986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATURAL DENTISTRY OF NORTH TEXAS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-29",
        "last_updated": "2014-12-29",
        "status": "A",
        "authorized_official_last_name": "OLSEN",
        "authorized_official_first_name": "GOTTFRED",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-616-7161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "12609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; 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.