Active NPI
Richard Brian Derksen, DMD
- General Practice Dentistry
- Dallas, TX
National Provider Identifier
1831400910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 24881
- Practice address
- 8201 Preston Rd
Suite 750
Dallas, TX 75225-6203 - Phone
- (214) 827-1150
- NPI assigned
- Jun 23, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 24881 | TX | Primary |
Addresses
Primary practice location
8201 Preston Rd
Suite 750
Dallas, TX 75225-6203
Mailing address
8201 Preston Rd
Suite 750
Dallas, TX 75225-6203
Phone (214) 827-1150
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24881 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dallas Esthetics, PLLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Dallas, TX
- NPI 1164591582
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369872000000",
"number": "1831400910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8201 PRESTON RD",
"address_2": "SUITE 750",
"city": "DALLAS",
"state": "TX",
"postal_code": "752256203",
"telephone_number": "214-827-1150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8201 PRESTON RD",
"address_2": "SUITE 750",
"city": "DALLAS",
"state": "TX",
"postal_code": "752256203",
"telephone_number": "214-827-1150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERKSEN",
"first_name": "RICHARD",
"middle_name": "BRIAN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-06-23",
"last_updated": "2013-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "24881",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.