NPIMap

Organization Active NPI

Saddle Creek Dental, PA

  • General Practice Dentistry
  • Waco, TX
National Provider Identifier
1669714721
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22305 Issued in TX
Legal business name
SADDLE CREEK DENTAL, PA
Practice address
10104 Saddle Creek Rd
Waco, TX 76708-7290
Phone
(254) 836-9595
NPI assigned
Mar 26, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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

Authorized official

Name
Dr. Dod David Moore, DDSNPI 1952429367
Title
President
Phone
(254) 836-9595

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 22305 TX Primary

Addresses

Primary practice location

10104 Saddle Creek Rd
Waco, TX 76708-7290

Mailing address

10104 Saddle Creek Rd
Waco, TX 76708-7290

National Provider Directory

National Provider Directory

Locations

10104 Saddle Creek Rd
Waco, TX 76708
Phone (254) 836-9595

Practitioners & affiliated clinicians

Practitioners 3

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": "1364256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364256000000",
    "number": "1669714721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10104 SADDLE CREEK RD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767087290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10104 SADDLE CREEK RD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767087290",
            "telephone_number": "254-836-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SADDLE CREEK DENTAL, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-26",
        "last_updated": "2013-03-26",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "DOD",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "254-836-9595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; 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.