Individual provider Active NPI

Michael Jay McQuade, DDS

  • Periodontics
  • Carrollton, TX
National Provider Identifier
1861514978
Registry record updated Mar 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
16756 Issued in TX
Practice address
1428 W Hebron Pkwy
Suite 140
Carrollton, TX 75010-6345
Phone
(972) 394-1234
Fax
(972) 394-1154
NPI assigned
Apr 6, 2007
Last updated
Mar 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 16756 TX Primary

Addresses

Primary practice location

1428 W Hebron Pkwy
Suite 140
Carrollton, TX 75010-6345

Mailing address

1428 W Hebron Pkwy
Suite 140
Carrollton, TX 75010-6345
Phone (972) 394-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141031001787 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2163643313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16756TXMDPeriodontist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394409600000",
    "number": "1861514978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 W HEBRON PKWY",
            "address_2": "SUITE 140",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750106345",
            "telephone_number": "972-394-1234",
            "fax_number": "972-394-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 W HEBRON PKWY",
            "address_2": "SUITE 140",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750106345",
            "telephone_number": "972-394-1234",
            "fax_number": "972-394-1154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCQUADE",
        "first_name": "MICHAEL",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2014-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "16756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

Verify at the official NPI Registry.