NPIMap

Organization Active NPI

Crowley Family Dental Center

Doing business as Modern Family Dental Hwy 1187

  • Exclusive Provider Organization
  • Crowley, TX
National Provider Identifier
1922423078
Registry record updated Feb 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
20899 Issued in TX
Legal business name
CROWLEY FAMILY DENTAL CENTER
Doing business as
Modern Family Dental Hwy 1187
Practice address
779 FM 1187 E
Crowley, TX 76036-4346
Phone
(807) 297-0058
Fax
(817) 297-7811
NPI assigned
Feb 26, 2014
Last updated
Feb 26, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2014

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

Authorized official

Name
Dr. Odalis Patricia Skur, DDSNPI 1235351495
Title
Doctor
Phone
(817) 297-0058

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 20899 TX Primary

Addresses

Primary practice location

779 FM 1187 E
Crowley, TX 76036-4346

Mailing address

779 FM 1187 E
Crowley, TX 76036-4346
Phone (807) 297-0058

Other identifiers 3

IdentifierTypeStateIssuer
1235351495OtherTXDELTA DENTAL
1447431523OtherTXDELTA DENTAL
1801093844OtherTXDELTA DENTAL

Other names 1

  • Modern Family Dental Hwy 1187 Doing business as

National Provider Directory

National Provider Directory

Locations

779 FM 1187 E
Crowley, TX 76036
Phone (817) 297-0058

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": "1393372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393372800000",
    "number": "1922423078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "779 FM 1187 E",
            "city": "CROWLEY",
            "state": "TX",
            "postal_code": "760364346",
            "telephone_number": "807-297-0058",
            "fax_number": "817-297-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "779 FM 1187 E",
            "city": "CROWLEY",
            "state": "TX",
            "postal_code": "760364346",
            "telephone_number": "807-297-0058",
            "fax_number": "817-297-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWLEY FAMILY DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-26",
        "last_updated": "2014-02-26",
        "status": "A",
        "authorized_official_last_name": "SKUR",
        "authorized_official_first_name": "ODALIS",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "817-297-0058",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "TX",
            "license": "20899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "1235351495",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "1447431523",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "1801093844",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Modern Family Dental Hwy 1187",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crowley, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2014; 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.