NPIMap

Organization Active NPI

Comfort Dental Centre Mesquite

  • Dentist
  • Mesquite, TX
National Provider Identifier
1649437245
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13654 Issued in TX
Legal business name
COMFORT DENTAL CENTRE MESQUITE
Practice address
3605 I-30 Ste C
Mesquite, TX 75150-2682
Phone
(972) 686-9000
NPI assigned
May 21, 2008
Last updated
May 21, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Authorized official

Name
Thelruth Shaw
Title
Ofc Manager
Phone
(972) 686-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 13654 TX Primary

Addresses

Primary practice location

3605 I-30 Ste C
Mesquite, TX 75150-2682

Mailing address

3605 I-30 Ste C
Mesquite, TX 75150-2682

Other identifiers 1

IdentifierTypeStateIssuer
090281902MedicaidTX

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1649437245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 I-30 STE C",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751502682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 I-30 STE C",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751502682",
            "telephone_number": "972-686-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORT DENTAL CENTRE MESQUITE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-21",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "THELRUTH",
        "authorized_official_title_or_position": "OFC MANAGER",
        "authorized_official_telephone_number": "972-686-9000"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "13654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090281902",
            "state": "TX"
        }
    ],
    "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 May 21, 2008; 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.