Individual provider Active NPI

Collette Alisabeth Edwards, DDS

  • General Practice Dentistry
  • San Marcos, TX
National Provider Identifier
1669992491
Registry record updated Feb 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
33186 Issued in TX
Practice address
301 W Hopkins St
San Marcos, TX 78666-4403
Phone
(512) 396-7268
NPI assigned
Jun 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2019

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 33186 TX Primary

Addresses

Primary practice location

301 W Hopkins St
San Marcos, TX 78666-4403

Mailing address

144 Landa St Apt 456
New Braunfels, TX 78130-7977
Phone (972) 955-3930

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
I20191014003635 TX Order and Referring Only - DentistPractitioner - Dentist 0941531404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1669992491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 LANDA ST APT 456",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781307977",
            "telephone_number": "972-955-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W HOPKINS ST",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786664403",
            "telephone_number": "512-396-7268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "COLLETTE",
        "middle_name": "ALISABETH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "33186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, TX

Sources for this page

Verify at the official NPI Registry.