Alicia Diane Ates, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

61936 Issued in KS

Practice address

3001 Wildflower Drive
Suite #511
Bryan, TX 77802

Phone

(979) 776-1040

Fax

(979) 776-1048

NPI assigned

Aug 9, 2018

Last updated

Apr 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Alicia Diane Morris Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alicia D Ates DDS LLC

  • General Practice Dentistry
  • Lenexa, KS
  • NPI 1134953953
  NPD Authorized official
• Bryan Modern Dentistry, PC

  dba Bryan Modern Dentistry

  • General Practice Dentistry
  • Bryan, TX
  • NPI 1568865798
  NPD (past)

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1942789110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3709 W 154TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662243862",
            "telephone_number": "903-277-9555",
            "fax_number": "979-776-1048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 WILDFLOWER DRIVE",
            "address_2": "SUITE #511",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "77802",
            "telephone_number": "979-776-1040",
            "fax_number": "979-776-1048"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10408 S Ridgeview Rd",
            "address_purpose": "LOCATION",
            "city": "Olathe",
            "state": "KS",
            "postal_code": "660616438",
            "country_code": "US",
            "telephone_number": "913-390-3555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATES",
        "first_name": "ALICIA",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-09",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "34476",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "61936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "MORRIS",
            "middle_name": "DIANE",
            "prefix": "MISS",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• General Practice Dentistry in Bryan, TX
• Providers in Bryan, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.