Titan Dental 1 PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

TITAN DENTAL 1 PLLC

Doing business as

Titan Dental

Practice address

1011 W Grande Blvd Ste 300
Tyler, TX 75703-6138

Phone

(903) 944-5284

NPI assigned

Aug 1, 2024

Last updated

Sep 16, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melissa Hernandez

Title

Regional Manager

Phone

(469) 803-0014

Specialties & licenses 1

Addresses

Other names 1

• Titan Dental Doing business as

Locations

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1760211189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 W GRANDE BLVD STE 300",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757036138",
            "telephone_number": "903-944-5284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 W GRANDE BLVD STE 300",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757036138",
            "telephone_number": "903-944-5284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TITAN DENTAL 1 PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "469-803-0014"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Titan Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.