Individual provider Active NPI

Allan S Parke, DDS

  • Prosthodontics
  • Jbsa Lackland, TX
National Provider Identifier
1831189794
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
34855 Issued in TX
Practice address
1615 Truemper St BLDG 6418
Jbsa Lackland, TX 78236-5511
Phone
(210) 292-1035
NPI assigned
Oct 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 34855 TX Primary

Addresses

Primary practice location

1615 Truemper St BLDG 6418
Jbsa Lackland, TX 78236-5511

Mailing address

16424 Revello Dr
Helotes, TX 78023-5159
Phone (850) 461-6839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1831189794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16424 REVELLO DR",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780235159",
            "telephone_number": "850-461-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 TRUEMPER ST BLDG 6418",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365511",
            "telephone_number": "210-292-1035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKE",
        "first_name": "ALLAN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "TX",
            "license": "34855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Lackland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.