NPIMap

Organization Active NPI

Dental Professionals of Texas, P.a.

Doing business as Granbury Dental Center

  • General Practice Dentistry
  • Granbury, TX
National Provider Identifier
1821307265
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF TEXAS, P.A.
Doing business as
Granbury Dental Center
Practice address
3412 E Highway 377
Granbury, TX 76049-7418
Phone
(817) 573-3761
Fax
(817) 573-3764
NPI assigned
Oct 4, 2010
Last updated
May 11, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF TEXAS, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Authorized official

Name
Cemyira Corbin
Title
Insurance/Credentialing
Phone
(217) 764-8609

Specialties & licenses 1

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

Addresses

Primary practice location

3412 E Highway 377
Granbury, TX 76049-7418

Mailing address

3412 E US Highway 377
Granbury, TX 76049-7418
Phone (817) 573-3761

Other names 1

  • Granbury Dental Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260422002182 TX Part B Supplier - Clinic/Group Practice 0648747113 Receives reassigned benefits from 1 practitioner
Practice locations: Granbury, TX

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Texas PA13 organizations share this tax ID, including this one
Part of
Dental Professionals of Texas PA

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3412 E US Highway 377
Granbury, TX 76049
Phone (817) 573-3761

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

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": "1286150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778457600000",
    "number": "1821307265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3412 E US HIGHWAY 377",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760497418",
            "telephone_number": "817-573-3761",
            "fax_number": "817-573-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3412 E HIGHWAY 377",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760497418",
            "telephone_number": "817-573-3761",
            "fax_number": "817-573-3764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF TEXAS, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF TEXAS, P.A.",
        "enumeration_date": "2010-10-04",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A",
        "authorized_official_last_name": "CORBIN",
        "authorized_official_first_name": "CEMYIRA",
        "authorized_official_title_or_position": "INSURANCE/CREDENTIALING",
        "authorized_official_telephone_number": "217-764-8609"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Granbury Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Granbury, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.