NPIMap

Organization Active NPI

Magnolia Dental

  • Dental Clinic/Center
  • Mabank, TX
National Provider Identifier
1699277228
Registry record updated Feb 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
22174 Issued in TX
Legal business name
MAGNOLIA DENTAL
Practice address
507 N 3Rd St
Mabank, TX 75147-8328
Phone
(903) 603-4406
Fax
(903) 201-6787
NPI assigned
Feb 28, 2018
Last updated
Feb 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2018

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

Authorized official

Name
Dr. Gerard Thomas Macy, DDSNPI 1972693976
Title
Dentist
Phone
(903) 603-4406

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
Dental Clinic/Center 261QD0000X 22174 TX Primary

Addresses

Primary practice location

507 N 3Rd St
Mabank, TX 75147-8328

Mailing address

507 N 3Rd St
Mabank, TX 75147-8328
Phone (903) 603-4406

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519776000000",
    "number": "1699277228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 N 3RD ST",
            "city": "MABANK",
            "state": "TX",
            "postal_code": "751478328",
            "telephone_number": "903-603-4406",
            "fax_number": "903-201-6787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 N 3RD ST",
            "city": "MABANK",
            "state": "TX",
            "postal_code": "751478328",
            "telephone_number": "903-603-4406",
            "fax_number": "903-201-6787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-28",
        "last_updated": "2018-02-28",
        "status": "A",
        "authorized_official_last_name": "MACY",
        "authorized_official_first_name": "GERARD",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "903-603-4406",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "22174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mabank, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; 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.