C. R. Heirtzler, Jr., D.D.S., Inc.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

6682 Issued in TX

Legal business name

C. R. HEIRTZLER, JR., D.D.S., INC.

Practice address

3312 Medical Triangle Drive
Port Arthur, TX 77642-2424

Phone

(409) 962-5311

Fax

(409) 963-3192

NPI assigned

Apr 9, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Clarence R Heirtzler Jr., D.D.S.

Title

President/Owner

Phone

(409) 962-5311

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207699200000",
    "number": "1942473178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3312 MEDICAL TRIANGLE DRIVE",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776422424",
            "telephone_number": "409-962-5311",
            "fax_number": "409-963-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3312 MEDICAL TRIANGLE DRIVE",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776422424",
            "telephone_number": "409-962-5311",
            "fax_number": "409-963-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C. R. HEIRTZLER, JR., D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-09",
        "last_updated": "2008-04-09",
        "status": "A",
        "authorized_official_last_name": "HEIRTZLER",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "409-962-5311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "6682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; 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.