Organization Active NPI

Excel Dental Clinic PA

  • Dentist
  • Dallas, TX
National Provider Identifier
1992810980
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
EXCEL DENTAL CLINIC PA
Practice address
3302 N Buckner
Ste 119
Dallas, TX 75228
Phone
(214) 320-3466
Fax
(214) 320-3444
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Authorized official

Name
Dr. Quyen Tu HuynhNPI 1881829653
Title
Managing Dentist
Phone
(469) 655-5221

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

Specialties & licenses 2

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

Addresses

Primary practice location

3302 N Buckner
Ste 119
Dallas, TX 75228

Mailing address

4709 Ravendale Dr
Richardson, TX 75082
Phone (972) 231-6382

Other practice location 1

655 W Illinois Ave Ste 920
Dallas, TX 75224-1814
Phone (214) 948-7621

Other identifiers 2

IdentifierTypeStateIssuer
150112402MedicaidTX
150112401MedicaidTX

National Provider Directory

National Provider Directory

Locations

655 W Illinois Ave
Ste 920
Dallas, TX 75224
Phone (214) 948-7621

3302 N Buckner Blvd
Ste 119
Dallas, TX 75228
Phone (214) 320-3466

Practitioners & affiliated clinicians

Practitioners 4

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": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666310400000",
    "number": "1992810980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4709 RAVENDALE DR",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "75082",
            "telephone_number": "972-231-6382",
            "fax_number": "972-271-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 N BUCKNER",
            "address_2": "STE 119",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75228",
            "telephone_number": "214-320-3466",
            "fax_number": "214-320-3444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 W Illinois Ave Ste 920",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752241814",
            "country_code": "US",
            "telephone_number": "214-948-7621",
            "fax_number": "214-943-3008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EXCEL DENTAL CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A",
        "authorized_official_last_name": "HUYNH",
        "authorized_official_first_name": "QUYEN",
        "authorized_official_middle_name": "TU",
        "authorized_official_title_or_position": "MANAGING DENTIST",
        "authorized_official_telephone_number": "469-655-5221",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150112402",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150112401",
            "state": "TX"
        }
    ],
    "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 Oct 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.

Verify at the official NPI Registry.