NPIMap

Organization Active NPI

Pecan Plaza Dental, P.a.

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1932257136
Registry record updated Mar 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PECAN PLAZA DENTAL, P.A.
Practice address
3400 Lombardy Lane
Suite 100
Dallas, TX 75220-3315
Phone
(214) 350-5333
Fax
(214) 350-8555
NPI assigned
Jan 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2016

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

Authorized official

Name
Dr. Robert E. Tafel, D.D.S.
Title
President
Phone
(214) 420-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3400 Lombardy Lane
Suite 100
Dallas, TX 75220-3315

Mailing address

PO Box 7302
Dallas, TX 75209-0302

Other identifiers 1

IdentifierTypeStateIssuer
160452201MedicaidTX

Other names 1

  • Bear Creek Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

3400 Lombardy Ln
Ste 100
Dallas, TX 75220
Phone (214) 350-5333

Practitioners & affiliated clinicians

Practitioners 9

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": "1168128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457049600000",
    "number": "1932257136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7302",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752090302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 LOMBARDY LANE",
            "address_2": "SUITE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752203315",
            "telephone_number": "214-350-5333",
            "fax_number": "214-350-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECAN PLAZA DENTAL, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-07",
        "last_updated": "2016-03-04",
        "status": "A",
        "authorized_official_last_name": "TAFEL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-420-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160452201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bear Creek Family Dentistry",
            "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 Mar 4, 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.