Organization Active NPI

Stephenville Family Dentistry

  • General Practice Dentistry
  • Stephenville, TX
National Provider Identifier
1619525565
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
STEPHENVILLE FAMILY DENTISTRY
Practice address
140 S Harbin Dr
Stephenville, TX 76401-3937
Phone
(254) 968-7980
NPI assigned
Sep 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Authorized official

Name
Brittany Eddy
Title
Credentialing Manager
Phone
(713) 869-4535

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

140 S Harbin Dr
Stephenville, TX 76401-3937

Mailing address

140 S Harbin Dr
Stephenville, TX 76401-3937
Phone (254) 968-7980

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address billing@memorialparkdental.com Direct

National Provider Directory

National Provider Directory

Locations

140 S Harbin Dr
Stephenville, TX 76401
Phone (254) 968-7980

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567468800000",
    "number": "1619525565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 S HARBIN DR",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764013937",
            "telephone_number": "254-968-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 S HARBIN DR",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764013937",
            "telephone_number": "254-968-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHENVILLE FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-03",
        "last_updated": "2019-09-03",
        "status": "A",
        "authorized_official_last_name": "EDDY",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "713-869-4535"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "billing@memorialparkdental.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "140 S Harbin Dr",
            "city": "Stephenville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "764013937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stephenville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.