Active NPI
James L Pavelka, D.D.S.
- General Practice Dentistry
- Denton, TX
National Provider Identifier
1942394481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9941
- Practice address
- 1300 Fulton St.
Suite 401
Denton, TX 76201 - Phone
- (940) 566-5332
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9941 | TX | Primary |
Addresses
Primary practice location
1300 Fulton St.
Suite 401
Denton, TX 76201
Mailing address
1300 Fulton St.
Suite 401
Denton, TX 76201
Phone (940) 566-5332
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00P736 | Other | TX | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942394481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 FULTON ST.",
"address_2": "SUITE 401",
"city": "DENTON",
"state": "TX",
"postal_code": "76201",
"telephone_number": "940-566-5332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 FULTON ST.",
"address_2": "SUITE 401",
"city": "DENTON",
"state": "TX",
"postal_code": "76201",
"telephone_number": "940-566-5332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAVELKA",
"first_name": "JAMES",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "9941",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "00P736",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Denton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.