Organization Active NPI

Epp TX PLLC

  • Endodontics
  • Dallas, TX
National Provider Identifier
1689396947
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
EPP TX PLLC
Practice address
12655 N Central Expy Ste 1014
Dallas, TX 75243-3792
Phone
(214) 972-3396
NPI assigned
Sep 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Authorized official

Name
Mr. Jason Bertollini
Title
Insurance Manager
Phone
(315) 450-0763

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

12655 N Central Expy Ste 1014
Dallas, TX 75243-3792

Mailing address

12655 N Central Expy Ste 1014
Dallas, TX 75243-3792

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1663113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663113600000",
    "number": "1689396947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12655 N CENTRAL EXPY STE 1014",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12655 N CENTRAL EXPY STE 1014",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433792",
            "telephone_number": "214-972-3396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPP TX PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-14",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A",
        "authorized_official_last_name": "BERTOLLINI",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "INSURANCE MANAGER",
        "authorized_official_telephone_number": "315-450-0763",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.