NPIMap

Organization Active NPI

Fifth Dental Partner PLLC

Doing business as Tesla Dentistry

  • General Practice Dentistry
  • Plano, TX
National Provider Identifier
1730722067
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FIFTH DENTAL PARTNER PLLC
Doing business as
Tesla Dentistry
Practice address
2831 W 15TH St Ste 200
Plano, TX 75075-7527
Phone
(972) 360-0805
NPI assigned
Oct 18, 2019
Last updated
Dec 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Authorized official

Name
Andy Chang, DDSNPI 1033133699
Title
Owner
Phone
(972) 360-0805

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2831 W 15TH St Ste 200
Plano, TX 75075-7527

Mailing address

2831 W 15TH St Ste 100
Plano, TX 75075-7527
Phone (469) 208-9800

Other identifiers 1

IdentifierTypeStateIssuer
1104040740MedicaidTX

Other names 1

  • Tesla Dentistry Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 7day.carestack.com

National Provider Directory

National Provider Directory

Locations

2831 W 15th St
Ste 100
Plano, TX 75075

2831 W 15th St
Ste 200
Plano, TX 75075
Phone (972) 360-0805

Practitioners & affiliated clinicians

Practitioners 2

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": "1571356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608249600000",
    "number": "1730722067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 W 15TH ST STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750757527",
            "telephone_number": "469-208-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2831 W 15TH ST STE 200",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750757527",
            "telephone_number": "972-360-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIFTH DENTAL PARTNER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-18",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "ANDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-360-0805",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104040740",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "7day.carestack.com",
            "affiliation": "N",
            "address_1": "2831 W 15th St Ste 200",
            "city": "Plano",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750757527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Tesla Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.