NPIMap

Organization Active NPI

Grandbury Dental , PLLC

  • General Practice Dentistry
  • Granbury, TX
National Provider Identifier
1902289143
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23695 Issued in TX
Legal business name
GRANDBURY DENTAL , PLLC
Practice address
708 Paluxy Rd
Granbury, TX 76048-2396
Phone
(817) 573-4600
NPI assigned
Jul 7, 2015
Last updated
Jul 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Authorized official

Name
Everett C Evans
Title
DDS, Owner
Phone
(940) 808-1970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 23695 TX Primary

Addresses

Primary practice location

708 Paluxy Rd
Granbury, TX 76048-2396

Mailing address

3600 E McKinney St
100
Denton, TX 76209-7557
Phone (940) 808-1970

National Provider Directory

National Provider Directory

Locations

708 Paluxy Rd
Granbury, TX 76048
Phone (817) 573-4600

NPI Registry JSON

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436227200000",
    "number": "1902289143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 E MCKINNEY ST",
            "address_2": "100",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762097557",
            "telephone_number": "940-808-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 PALUXY RD",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760482396",
            "telephone_number": "817-573-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANDBURY DENTAL , PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-07",
        "last_updated": "2015-07-07",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "EVERETT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DDS, OWNER",
        "authorized_official_telephone_number": "940-808-1970"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granbury, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; 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.