Organization Active NPI

Katy Trail Dental PLLC

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1861718934
Registry record updated Apr 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
KATY TRAIL DENTAL PLLC
Doing business as
Katy Trail Dental
Practice address
4152 Buena Vista St
Dallas, TX 75204-7813
Phone
(214) 520-1112
Fax
(214) 520-1190
NPI assigned
Apr 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2010

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

Authorized official

Name
G. Scott Marshall, DDS
Title
Owner/Partner
Phone
(903) 455-2942

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

4152 Buena Vista St
Dallas, TX 75204-7813

Mailing address

17480 Dallas Pkwy
Suite 213
Dallas, TX 75287-7337
Phone (972) 248-1221

Other names 1

  • Katy Trail Dental Doing business as

National Provider Directory

National Provider Directory

Locations

4152 Buena Vista St
Dallas, TX 75204
Phone (214) 520-1112

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": "1271203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271203200000",
    "number": "1861718934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17480 DALLAS PKWY",
            "address_2": "SUITE 213",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752877337",
            "telephone_number": "972-248-1221",
            "fax_number": "972-248-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4152 BUENA VISTA ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752047813",
            "telephone_number": "214-520-1112",
            "fax_number": "214-520-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATY TRAIL DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-14",
        "last_updated": "2010-04-14",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "G.",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "903-455-2942",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Katy Trail Dental",
            "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 Apr 14, 2010; 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.