Ace Dental03 PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

29291 Issued in TX

Legal business name

ACE DENTAL03 PC

Practice address

100 Carlos G. Parker Blvd
110
Taylor, TX 76574

Phone

(201) 925-0210

NPI assigned

Dec 30, 2015

Organization subpart

No

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

Authorized official

Name

Aditi Gupta

Title

Owner/Provider

Phone

(201) 925-0210

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451433600000",
    "number": "1720443161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CARLOS G. PARKER BLVD",
            "address_2": "110",
            "city": "TAYLOR",
            "state": "TX",
            "postal_code": "76574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CARLOS G. PARKER BLVD",
            "address_2": "110",
            "city": "TAYLOR",
            "state": "TX",
            "postal_code": "76574",
            "telephone_number": "201-925-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACE DENTAL03 PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-30",
        "last_updated": "2015-12-30",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "ADITI",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "201-925-0210"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "29291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 920 North Main Street Professional, PLLC
• Adeniyi Adediran
• Sarai Albert, PA-C
• Amos N. Wolf
• Samantha Anderson, PA-C
• Shannon Chenay Anderson, FNP-C

• General Practice Dentistry in Taylor, TX
• Providers in Taylor, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2015; 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.