Whitewing Dental at la Feria,PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

28714 Issued in TX

Legal business name

WHITEWING DENTAL AT LA FERIA,PLLC

Practice address

200 W 1St St
La Feria, TX 78559-5000

Phone

(956) 797-3131

Fax

(956) 797-3232

NPI assigned

Jan 19, 2018

Organization subpart

No

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

Authorized official

Name

David C Gray, DMD

Title

Owner/Dentist

Phone

(956) 797-3131

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1516320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516320000000",
    "number": "1609384098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W 1ST ST",
            "city": "LA FERIA",
            "state": "TX",
            "postal_code": "785595000",
            "telephone_number": "956-797-3131",
            "fax_number": "956-797-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W 1ST ST",
            "city": "LA FERIA",
            "state": "TX",
            "postal_code": "785595000",
            "telephone_number": "956-797-3131",
            "fax_number": "956-797-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITEWING DENTAL AT LA FERIA,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-19",
        "last_updated": "2018-01-19",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "956-797-3131",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "28714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "329444910",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.