NPIMap

Organization Active NPI

My Local Texas Dental Practice, PLLC

Doing business as Jarrell Family Dentistry

  • General Practice Dentistry
  • Jarrell, TX
National Provider Identifier
1952046948
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MY LOCAL TEXAS DENTAL PRACTICE, PLLC
Doing business as
Jarrell Family Dentistry
Practice address
181 Town Center Blvd Ste 100
Jarrell, TX 76537-4002
Phone
(512) 746-5222
NPI assigned
May 3, 2022
Last updated
May 3, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
MY LOCAL TEXAS DENTAL PRACTICE, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Authorized official

Name
Gregory Kostelac
Title
Data Analyst
Phone
(719) 372-5605

Specialties & licenses 1

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

Addresses

Primary practice location

181 Town Center Blvd Ste 100
Jarrell, TX 76537-4002

Mailing address

6110 Barnes Rd
Colorado Springs, CO 80922-2600

Other names 1

  • Jarrell Family Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
My Local Texas Dental Practice PLLC16 organizations share this tax ID, including this one
Part of
My Local Texas Dental Practice PLLC

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

181 Town Center Blvd
Ste 100
Jarrell, TX 76537
Phone (512) 746-5222

NPI Registry JSON

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

{
    "created_epoch": "1651536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651536000000",
    "number": "1952046948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6110 BARNES RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809222600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 TOWN CENTER BLVD STE 100",
            "city": "JARRELL",
            "state": "TX",
            "postal_code": "765374002",
            "telephone_number": "512-746-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY LOCAL TEXAS DENTAL PRACTICE, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MY LOCAL TEXAS DENTAL PRACTICE, PLLC",
        "enumeration_date": "2022-05-03",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A",
        "authorized_official_last_name": "KOSTELAC",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "DATA ANALYST",
        "authorized_official_telephone_number": "719-372-5605"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jarrell Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jarrell, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; 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.