Organization Active NPI

Buckner Rsvglc PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Dallas, TX
National Provider Identifier
1851944706
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
BUCKNER RSVGLC PLLC
Practice address
2702 S Buckner Blvd # 111
Dallas, TX 75227-6903
Phone
(214) 493-1216
NPI assigned
Jul 19, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Authorized official

Name
Nina Abtahi
Title
Manager
Phone
(214) 493-1216

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

2702 S Buckner Blvd # 111
Dallas, TX 75227-6903

Mailing address

2702 S Buckner Blvd # 111
Dallas, TX 75227-6903
Phone (214) 493-1216

Other names 1

  • Alta Orthodontics and Dental Specialists Doing business as

National Provider Directory

National Provider Directory

Locations

2702 S Buckner Blvd
#111
Dallas, TX 75227

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": "1563494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563494400000",
    "number": "1851944706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 S BUCKNER BLVD # 111",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752276903",
            "telephone_number": "214-493-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 S BUCKNER BLVD # 111",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752276903",
            "telephone_number": "214-493-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKNER RSVGLC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-19",
        "last_updated": "2019-07-19",
        "status": "A",
        "authorized_official_last_name": "ABTAHI",
        "authorized_official_first_name": "NINA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "214-493-1216"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alta Orthodontics and Dental Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 19, 2019; 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.