Allen Gandy, DDS, MS
Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Fairview, TX
NPI 1770801607 · NPPES record last updated May 17, 2010
Key facts
- NPI
- 1770801607
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- 20817 (TX)
- Practice address
- 431 New Stacy Rd Ste 109
Fairview, TX 75069-8717 - Phone
- (972) 727-3900
- Fax
- (972) 727-3901
- NPI assigned
- May 17, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20817 | TX | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview-Allen Orthodontics, PA | Orthodontics and Dentofacial Orthopedics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 20817 | TX | Yes |
Addresses
Primary practice location
431 New Stacy Rd Ste 109
Fairview, TX 75069-8717
Mailing address
431 New Stacy Rd Ste 109
Fairview, TX 75069-8717
Phone (972) 727-3900
Other providers in Fairview, TX
- Fairview Dermatology PLLC
- Fairview-Allen Orthodontics, PA
- Tina Feng
- Sophia Fluty
- Lauren Michelle Fox
- Jenny Marie Garner
- Harneet Kaur Ghumman
- Upinder Singh Ghumman
- Annali Goette
- Patrick Green
All providers in Fairview, TX · Orthodontics and Dentofacial Orthopedics Dentistry in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.