Gleam Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

License

23874 Issued in TX

Legal business name

GLEAM DENTAL LLC

Practice address

3636 N. Macaurthur
Ste 140
Irving, TX 75062

Phone

(972) 573-6100

Fax

(972) 573-6105

NPI assigned

Feb 15, 2012

Organization subpart

Yes

Parent organization

GLEAM DENTALAs reported in NPPES

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

Authorized official

Name

Field G. Harrison, DDS

Title

Owner/Provider

Phone

(972) 573-6100

Specialties & licenses 2

Addresses

Other identifiers 1

Part of

Gleam Dental LLC

Locations

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329264000000",
    "number": "1679846083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 N. MACAURTHUR",
            "address_2": "STE. 140",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "75062",
            "telephone_number": "972-573-6100",
            "fax_number": "972-573-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 N. MACAURTHUR",
            "address_2": "STE 140",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "75062",
            "telephone_number": "972-573-6100",
            "fax_number": "972-573-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEAM DENTAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GLEAM DENTAL",
        "enumeration_date": "2012-02-15",
        "last_updated": "2012-02-15",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "FIELD",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "972-573-6100",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "23874",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TPI205977609",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Irving, TX
• Providers in Irving, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.