NPIMap

Organization Active NPI

Ennis Dental PLLC

  • General Practice Dentistry
  • Ennis, TX
National Provider Identifier
1821471061
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23695 Issued in TX
Legal business name
ENNIS DENTAL PLLC
Practice address
1012 E Ennis Ave
Suite C
Ennis, TX 75119-4345
Phone
(972) 875-2501
NPI assigned
Jul 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Authorized official

Name
Dr. Everett C Evans
Title
DDS, Owner
Phone
(940) 808-1970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 23695 TX Primary

Addresses

Primary practice location

1012 E Ennis Ave
Suite C
Ennis, TX 75119-4345

Mailing address

3600 E McKinney St
100
Denton, TX 76209-7557
Phone (940) 808-1970

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436227200000",
    "number": "1821471061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 E MCKINNEY ST",
            "address_2": "100",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762097557",
            "telephone_number": "940-808-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 E ENNIS AVE",
            "address_2": "SUITE C",
            "city": "ENNIS",
            "state": "TX",
            "postal_code": "751194345",
            "telephone_number": "972-875-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENNIS DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-07",
        "last_updated": "2015-07-07",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "EVERETT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DDS, OWNER",
        "authorized_official_telephone_number": "940-808-1970",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ennis, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; 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.