Permian Basin Dental Group

Primary specialty

DentistTaxonomy code 122300000X

License

12663 Issued in TX

Legal business name

PERMIAN BASIN DENTAL GROUP

Practice address

2631 Faudree Rd Unit B
Odessa, TX 79765-8530

Phone

(432) 563-1760

Fax

(432) 563-1763

NPI assigned

Apr 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Welby Higgins, D.D.S.NPI 1043372949

Title

Owner

Phone

(432) 563-1760

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth Welby Higgins, D.D.S.

  • General Practice Dentistry
  • Odessa, TX
  • NPI 1043372949
  NPD (past) Authorized official
• Ashley Nguyen

  • Dentist
  • Midland, TX
  • NPI 1952161846
  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344384000000",
    "number": "1972625978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2631 FAUDREE RD UNIT B",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797658530",
            "telephone_number": "432-563-1760",
            "fax_number": "432-563-1763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2631 FAUDREE RD UNIT B",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797658530",
            "telephone_number": "432-563-1760",
            "fax_number": "432-563-1763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERMIAN BASIN DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2012-08-08",
        "status": "A",
        "authorized_official_last_name": "HIGGINS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "WELBY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "432-563-1760",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "12663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177458001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Permian Basin Ambulance Inc.
• Permian Basin Caring Hearts Home Health Inc (Caring Hearts Home Health of the Permian Basin)
• Permian Basin Community Centers for MHMR
• Permian Basin Community Centers for MHMR
• Permian Basin Community Centers for MHMR
• Permian Basin DME
• Permian Basin Kidney Center Inc
• Permian Basin Oral Surgery & Dental Implant Center (Permian Basin Oral Surgery)
• Permian Basin Practice Exchange
• Permian Basin Radiology, LLC

• Dentist in Odessa, TX
• Providers in Odessa, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; 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.