Organization Active NPI

Legacy Dental of Glen Oaks

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1962881748
Registry record updated May 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
25393 Issued in TX
Legal business name
LEGACY DENTAL OF GLEN OAKS
Practice address
4767 Vista Wood Blvd
Ste 110
Dallas, TX 75232
Phone
(214) 321-8383
NPI assigned
May 26, 2015
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Michael Gerald Heffelfinger, DDSNPI 1295055739
Title
Owner
Phone
(972) 563-8383

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory

Locations

4767 Vista Wood Blvd
Ste 110
Dallas, TX 75232
Phone (214) 321-8383

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 25393 TX Primary

Addresses

NPPES NPI Registry

Primary practice location

4767 Vista Wood Blvd
Ste 110
Dallas, TX 75232

Mailing address

4767 Vista Wood Blvd
Ste 110
Dallas, TX 75232

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 26, 2015.

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432598400000",
    "number": "1962881748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4767 VISTA WOOD BLVD",
            "address_2": "STE 110",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4767 VISTA WOOD BLVD",
            "address_2": "STE 110",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75232",
            "telephone_number": "214-321-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY DENTAL OF GLEN OAKS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-26",
        "last_updated": "2015-05-26",
        "status": "A",
        "authorized_official_last_name": "HEFFELFINGER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "GERALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-563-8383",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; 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.