Individual provider Active NPI

Dan Alan Necker, D.D.S.

  • General Practice Dentistry
  • Austin, TX
National Provider Identifier
1639284805
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14426 Issued in TX
Practice address
2719 E 7TH St
Austin, TX 78702-3907
Phone
(512) 473-8444
Fax
(512) 473-2025
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 14426 TX Primary

Addresses

Primary practice location

2719 E 7TH St
Austin, TX 78702-3907

Mailing address

39 Hedgebrook Way
The Hills, TX 78738-1319
Phone (512) 261-4676

Other identifiers 1

IdentifierTypeStateIssuer
009623201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160420000702 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7315245693

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14426TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Central Family Dental Center Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1639284805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 HEDGEBROOK WAY",
            "city": "THE HILLS",
            "state": "TX",
            "postal_code": "787381319",
            "telephone_number": "512-261-4676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2719 E 7TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787023907",
            "telephone_number": "512-473-8444",
            "fax_number": "512-473-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NECKER",
        "first_name": "DAN",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "14426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009623201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.