Active NPI
Alex Edgerly, D.D.S.
- Dentist
- Port Arthur, TX
National Provider Identifier
1982134011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 32908
- Practice address
- 3140 Central Mall Dr
Port Arthur, TX 77642-8039 - Phone
- (409) 727-2164
- NPI assigned
- Jun 12, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 32908 | TX | Primary |
Addresses
Primary practice location
3140 Central Mall Dr
Port Arthur, TX 77642-8039
Mailing address
3140 Central Mall Dr
Port Arthur, TX 77642-8039
Phone (409) 727-2164
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
| License | State | Type | Specialty |
|---|---|---|---|
| 32908 | TX | MD | Community/Retail Pharmacy |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smiles by Design, PLLC | Past | Accepting new patients | |
| Dr. Michael Scott Bartlett, DDS, PC | Dentist | Past | 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.
-
- Dentist
- Port Arthur, TX
- NPI 1366878753
-
- General Practice Dentistry
- Port Arthur, TX
- NPI 1326976978
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1982134011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3140 CENTRAL MALL DR",
"city": "PORT ARTHUR",
"state": "TX",
"postal_code": "776428039",
"telephone_number": "409-727-2164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3140 CENTRAL MALL DR",
"city": "PORT ARTHUR",
"state": "TX",
"postal_code": "776428039",
"telephone_number": "409-727-2164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDGERLY",
"first_name": "ALEX",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-12",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "32908",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Arthur, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.