NPIMap

Organization Active NPI

Dallas Endodontics, P.a.

  • Endodontics
  • Dallas, TX
National Provider Identifier
1902954472
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
19484 Issued in TX
Legal business name
DALLAS ENDODONTICS, P.A.
Practice address
11910 Greenville Ave
Suite 450
Dallas, TX 75243-3596
Phone
(972) 644-1162
Fax
(972) 783-6660
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

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

Authorized official

Name
Lori Willis
Title
Administrative Asst.
Phone
(972) 644-1162

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X 10924 TX
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X 16886 TX
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X 19484 TX Primary

Addresses

Primary practice location

11910 Greenville Ave
Suite 450
Dallas, TX 75243-3596

Mailing address

11910 Greenville Ave
Suite 450
Dallas, TX 75243-3596
Phone (972) 644-1162

National Provider Directory

National Provider Directory

Locations

11910 Greenville Ave
Ste 450
Dallas, TX 75243
Phone (972) 644-1162

Practitioners & affiliated clinicians

Practitioners 4

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": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453680000000",
    "number": "1902954472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11910 GREENVILLE AVE",
            "address_2": "SUITE 450",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433596",
            "telephone_number": "972-644-1162",
            "fax_number": "972-783-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11910 GREENVILLE AVE",
            "address_2": "SUITE 450",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433596",
            "telephone_number": "972-644-1162",
            "fax_number": "972-783-6660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALLAS ENDODONTICS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2016-01-25",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASST.",
        "authorized_official_telephone_number": "972-644-1162"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "10924",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "16886",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "19484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 25, 2016; 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.