NPIMap

Organization Active NPI

My Local Texas Dental Practice, PLLC

  • General Practice Dentistry
  • Sealy, TX
National Provider Identifier
1679201024
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MY LOCAL TEXAS DENTAL PRACTICE, PLLC
Practice address
226 4TH St
Sealy, TX 77474-2726
Phone
(719) 266-2717
Fax
(719) 213-2311
NPI assigned
Aug 12, 2022
Organization subpart
Yes
Parent organization
MY LOCAL TEXAS DENTAL PRACTICE, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Authorized official

Name
Silas Charles Erickson
Title
Credentialing Specialist
Phone
(720) 353-4903

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

226 4TH St
Sealy, TX 77474-2726

Mailing address

6110 Barnes Rd
Colorado Springs, CO 80922-2600
Phone (719) 266-2717

Other names 1

  • Sealy Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
My Local Texas Dental Practice PLLC16 organizations share this tax ID, including this one
Part of
My Local Texas Dental Practice PLLC

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1679201024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6110 BARNES RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809222600",
            "telephone_number": "719-266-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 4TH ST",
            "city": "SEALY",
            "state": "TX",
            "postal_code": "774742726",
            "telephone_number": "719-266-2717",
            "fax_number": "719-213-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY LOCAL TEXAS DENTAL PRACTICE, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MY LOCAL TEXAS DENTAL PRACTICE, PLLC",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "SILAS",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "720-353-4903"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sealy Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sealy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; 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.