Active NPI
Dallin Lyman Duncan, DDS
- Dentist
- Fort Cavazos, TX
National Provider Identifier
1609502079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12880095-9921
- Practice address
- 36000 Shoemaker Lane
Suite 1051
Fort Cavazos, TX 76544-5054 - Phone
- (254) 287-2705
- NPI assigned
- Jul 28, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 12880095-9921 | UT | Primary |
Addresses
Primary practice location
36000 Shoemaker Lane
Suite 1051
Fort Cavazos, TX 76544-5054
Mailing address
36000 Shoemaker Lane
Suite 1051
Fort Cavazos, TX 76544
Phone (254) 287-2705
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12880095-9921 | UT | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690243200000",
"number": "1609502079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36000 SHOEMAKER LANE",
"address_2": "SUITE 1051",
"city": "FORT CAVAZOS",
"state": "TX",
"postal_code": "76544",
"telephone_number": "254-287-2705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36000 SHOEMAKER LANE",
"address_2": "SUITE 1051",
"city": "FORT CAVAZOS",
"state": "TX",
"postal_code": "765445054",
"telephone_number": "254-287-2705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNCAN",
"first_name": "DALLIN",
"middle_name": "LYMAN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-28",
"last_updated": "2023-07-25",
"certification_date": "2023-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "12880095-9921",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Cavazos, TX
- Chris Dire
- Linda A Dixon-Victor, MSN, FNP-BC, BSN, RN
- Michael Angelo Carillo Duenas, P.T.
- Bria Margaret Lashae Dukes, LCSW
- Shannen Lynn Dumond, RN, MSN, CPNP
- James Dungca, M.D.
- Toritsetimiyin Marian E-Nunu, M.D., MPH
- Jenifer Elizabeth Edmondson, MD
- Michael Jiovanni Elliott, PA-C
- Christine Lynn Ellis, APRN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.