Individual provider Active NPI

Michael Joseph Neeley, DDS

  • Dentist
  • Dallas, TX
National Provider Identifier
1760493423
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11206 Issued in TX
Practice address
3131 Harvard Ave
Suite 101
Dallas, TX 75205-3443
Phone
(214) 521-3148
Fax
(214) 521-3186
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11206 TX Primary

Addresses

Primary practice location

3131 Harvard Ave
Suite 101
Dallas, TX 75205-3443

Mailing address

3131 Harvard Ave
Suite 101
Dallas, TX 75205-3443
Phone (214) 521-3148

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11206TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760493423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 HARVARD AVE",
            "address_2": "SUITE 101",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752053443",
            "telephone_number": "214-521-3148",
            "fax_number": "214-521-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 HARVARD AVE",
            "address_2": "SUITE 101",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752053443",
            "telephone_number": "214-521-3148",
            "fax_number": "214-521-3186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEELEY",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "11206",
            "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 Jul 8, 2007; 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.