NPIMap

Organization Active NPI

Midentista, PLLC

  • Dentist
  • Irving, TX
National Provider Identifier
1922335272
Registry record updated Nov 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
18837 Issued in TX
Legal business name
MIDENTISTA, PLLC
Practice address
101 Decker
BLDG. 200, Ste. 260
Irving, TX 75062
Phone
(972) 717-0660
Fax
(972) 717-0663
NPI assigned
Nov 6, 2009
Last updated
Nov 6, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2009

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

Authorized official

Name
Dr. Angel Gonzalez Jr., DDSNPI 1740305655
Title
President
Phone
(972) 717-0660

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 18837 TX Primary

Addresses

Primary practice location

101 Decker
BLDG. 200, Ste. 260
Irving, TX 75062

Mailing address

101 Decker
BLDG. 200, Ste. 260
Irving, TX 75062
Phone (972) 717-0660

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1257465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257465600000",
    "number": "1922335272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DECKER",
            "address_2": "BLDG. 200, STE. 260",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "75062",
            "telephone_number": "972-717-0660",
            "fax_number": "972-717-0663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DECKER",
            "address_2": "BLDG. 200, STE. 260",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "75062",
            "telephone_number": "972-717-0660",
            "fax_number": "972-717-0663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDENTISTA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-06",
        "last_updated": "2009-11-06",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-717-0660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "18837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; 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.