NPIMap

Organization Active NPI

New Avenue Dentistry, PLLC

  • Dentist
  • Irving, TX
National Provider Identifier
1821549403
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
29312 Issued in TX
Legal business name
NEW AVENUE DENTISTRY, PLLC
Practice address
3007 Skyway Cir N
Suite 100
Irving, TX 75038-3524
Phone
(972) 905-1359
NPI assigned
Oct 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

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

Authorized official

Name
Dr. Michael Fooshee, D.D.S.NPI 1265795538
Title
President
Phone
(972) 905-1359

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 29312 TX Primary

Addresses

Primary practice location

3007 Skyway Cir N
Suite 100
Irving, TX 75038-3524

Mailing address

3007 Skyway Cir N
Suite 100
Irving, TX 75038-3524

Other names 1

  • New Avenue Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

3007 Skyway Cir N
Ste 100
Irving, TX 75038
Phone (972) 905-1359

Practitioners & affiliated clinicians

Practitioners 1

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": "1476835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476835200000",
    "number": "1821549403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3007 SKYWAY CIR N",
            "address_2": "SUITE 100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3007 SKYWAY CIR N",
            "address_2": "SUITE 100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383524",
            "telephone_number": "972-905-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW AVENUE DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-19",
        "last_updated": "2016-10-19",
        "status": "A",
        "authorized_official_last_name": "FOOSHEE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-905-1359",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "29312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Avenue Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; 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.