NPIMap

Organization Active NPI

TX Southern Dental PPO PC

  • General Practice Dentistry
  • Plano, TX
National Provider Identifier
1982203873
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TX SOUTHERN DENTAL PPO PC
Practice address
6841 Coit Rd
Plano, TX 75024-5489
Phone
(972) 618-5000
Fax
(972) 618-9369
NPI assigned
Oct 21, 2020
Organization subpart
Yes
Parent organization
TX SOUTHERN DENTAL PPO PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Authorized official

Name
Christine Nelson
Title
VP, Revenue Cycle
Phone
(469) 450-6482

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

6841 Coit Rd
Plano, TX 75024-5489

Mailing address

5830 Granite Pkwy Ste 780
Plano, TX 75024-6775

Other names 1

  • Imagecare Dental Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
TX Southern Dental PPO PC40 organizations share this tax ID, including this one
Part of
TX Southern Dental PPO PC

Other organizations with this tax ID 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704412800000",
    "number": "1982203873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5830 GRANITE PKWY STE 780",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750246775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6841 COIT RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750245489",
            "telephone_number": "972-618-5000",
            "fax_number": "972-618-9369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TX SOUTHERN DENTAL PPO PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TX SOUTHERN DENTAL PPO PC",
        "enumeration_date": "2020-10-21",
        "last_updated": "2024-01-05",
        "certification_date": "2023-07-28",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "VP, REVENUE CYCLE",
        "authorized_official_telephone_number": "469-450-6482"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Imagecare Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; 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.