Active NPI
Jonathan Ray Heizer, DDS
- General Practice Dentistry
- Granbury, TX
National Provider Identifier
1649471855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 21719
- Practice address
- 915 W Pearl St
Granbury, TX 76048-2051 - Phone
- (817) 573-3724
- Fax
- (817) 573-9251
- NPI assigned
- May 29, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 21719 | TX | Primary |
Addresses
Primary practice location
915 W Pearl St
Granbury, TX 76048-2051
Mailing address
915 W Pearl St
Granbury, TX 76048-2051
Phone (817) 573-3724
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 |
|---|---|---|---|
| 21719 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649471855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "915 W PEARL ST",
"city": "GRANBURY",
"state": "TX",
"postal_code": "760482051",
"telephone_number": "817-573-3724",
"fax_number": "817-573-9251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 W PEARL ST",
"city": "GRANBURY",
"state": "TX",
"postal_code": "760482051",
"telephone_number": "817-573-3724",
"fax_number": "817-573-9251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEIZER",
"first_name": "JONATHAN",
"middle_name": "RAY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "21719",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Granbury, TX
- Heart Center of North Texas, PA (Heart Center of North Texas)
- Heart Center of North Texas, PA (Heart Center of North Texas)
- Heartland Dental Care of TX, PC (Granbury Dental Center- Pecan Plantation)
- Tony Gene Hedges, D.O.
- Kirankumar Hegde
- Karissa Heller, CCC-SLP
- Kelly Cario Hernandez, FNP-C
- Lawrence Robert Hess, F.N.P.
- Nance D Hicks, D0
- Hill Country Radiology Associates PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.