Payne & Boatner DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

20864 Issued in TX

Legal business name

PAYNE & BOATNER DDS PC

Practice address

1760 Rufe Snow Dr
Keller, TX 76248-5628

Phone

(817) 498-3889

Fax

(817) 281-2810

NPI assigned

Jul 2, 2012

Last updated

Jul 6, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Glenn M Payne, DDSNPI 1508937251

Title

President

Phone

(817) 498-3889

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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.

• Glenn Morris Payne, DDS

  • Dentist
  • Keller, TX
  • NPI 1508937251
  NPD Authorized official
• Charles Knox Boatner, DDS

  • Dentist
  • Keller, TX
  • NPI 1285729285
  NPD
• David S Harris, D.D.S.

  • General Practice Dentistry
  • Keller, TX
  • NPI 1104112135
  NPD (past)

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657065600000",
    "number": "1851655146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 RUFE SNOW DR",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762485628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 RUFE SNOW DR",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762485628",
            "telephone_number": "817-498-3889",
            "fax_number": "817-281-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAYNE & BOATNER DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-02",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-498-3889",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "20864",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sneha Patel, CPNP - PC
• Pathos Clinical Solutions LLC
• Pathway to Healing Counseling, PLLC
• Tess Maryruth Patterson, RD LD
• Bartholomew Mackay Paxton, D.D.S
• Glenn Morris Payne, DDS
• Carley Pearce, D.C.
• Gina L Pearson, LLP, LPA
• Rachel Pedersen
• Pediatric Dentistry of Keller PLLC

• Dentist in Keller, TX
• Providers in Keller, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; 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.