NPIMap

Organization Active NPI

Ideal Dental of University Park, PLLC

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1972885291
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22290 Issued in TX
Legal business name
IDEAL DENTAL OF UNIVERSITY PARK, PLLC
Practice address
8611 Hillcrest Ave
Suite 250
Dallas, TX 75225-4207
Phone
(214) 361-3550
NPI assigned
Sep 13, 2011
Last updated
Sep 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Authorized official

Name
Carol L Cantu
Title
Insurance Specialist
Phone
(817) 571-3368

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 22290 TX Primary

Addresses

Primary practice location

8611 Hillcrest Ave
Suite 250
Dallas, TX 75225-4207

Mailing address

8611 Hillcrest Ave
Suite 250
Dallas, TX 75225-4207
Phone (214) 361-3550

National Provider Directory

National Provider Directory

Locations

8611 Hillcrest Ave
Ste 250
Dallas, TX 75225
Phone (214) 361-3550

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1972885291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8611 HILLCREST AVE",
            "address_2": "SUITE 250",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752254207",
            "telephone_number": "214-361-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8611 HILLCREST AVE",
            "address_2": "SUITE 250",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752254207",
            "telephone_number": "214-361-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL DENTAL OF UNIVERSITY PARK, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "CANTU",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "INSURANCE SPECIALIST",
        "authorized_official_telephone_number": "817-571-3368"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22290",
            "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 Sep 13, 2011; 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.