Michael Ross Drennan, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

23408 Issued in TX

Practice address

220 Shops Blvd
Willow Park, TX 76087-4375

Phone

(817) 441-7654

Fax

(817) 441-6168

NPI assigned

Jul 19, 2007

Last updated

Jan 24, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Crown Pointe Dentistry, PA

  • Dentist
  • Willow Park, TX
  • NPI 1033591359
  NPD (past)

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1790985513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 SHOPS BLVD",
            "city": "WILLOW PARK",
            "state": "TX",
            "postal_code": "76087",
            "telephone_number": "817-441-7654",
            "fax_number": "817-441-6168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SHOPS BLVD",
            "city": "WILLOW PARK",
            "state": "TX",
            "postal_code": "760874375",
            "telephone_number": "817-441-7654",
            "fax_number": "817-441-6168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRENNAN",
        "first_name": "MICHAEL",
        "middle_name": "ROSS",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-19",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "23408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misty Diaz
• Matthew Dobbins, DPT
• Skylar Dominguez, RBT
• Ashley Drake Mertz, LMFT
• Chad Lamar Drennan, D.D.S.
• Brynn Dunn
• Ebd Bemc Burleson, LLC (Baylor Scott & White Hospital-Willow Park)
• Corinna Edgington, RBT
• Hannah Elder, RBT
• Diana Enciso Romero, BCBA

• Dentist in Willow Park, TX
• Providers in Willow Park, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.