Individual provider Active NPI

Lauren Michelle Nelson, DDS

  • Pediatric Dentistry
  • Gainesville, TX
National Provider Identifier
1962776617
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
28119 Issued in TX
Practice address
321 N Grand Ave
Gainesville, TX 76240-4321
Phone
(940) 665-0700
NPI assigned
Feb 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Dentistry 1223P0221X 28119 TX Primary

Addresses

Primary practice location

321 N Grand Ave
Gainesville, TX 76240-4321

Mailing address

4514 Rockaway Dr
Dallas, TX 75214-2549
Phone (817) 789-9712

Other practice location 1

8355 Walnut Hill Ln Ste 125
Dallas, TX 75231-4237
Phone (214) 378-8868

Other practice location 2

501 S Stemmons Fwy
Lewisville, TX 75067-4562
Phone (972) 436-9121

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

State licenses

LicenseStateTypeSpecialty
28119TXMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lara Kirstin Holly DMD PA Past Accepting new patients
North Texas Children's Dentistry, PLLC Pediatric Dentistry PastSince May 25, 2021 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1330300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1962776617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4514 ROCKAWAY DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752142549",
            "telephone_number": "817-789-9712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N GRAND AVE",
            "city": "GAINESVILLE",
            "state": "TX",
            "postal_code": "762404321",
            "telephone_number": "940-665-0700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8355 Walnut Hill Ln Ste 125",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752314237",
            "country_code": "US",
            "telephone_number": "214-378-8868",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 S Stemmons Fwy",
            "address_purpose": "LOCATION",
            "city": "Lewisville",
            "state": "TX",
            "postal_code": "750674562",
            "country_code": "US",
            "telephone_number": "972-436-9121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "LAUREN",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-27",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "28119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; 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.