1902267636 NPI number — PREECE DENTISTRY PLLC

Table of content: (NPI 1902267636)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902267636 NPI number — PREECE DENTISTRY PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PREECE DENTISTRY PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PREECE DENTISTRY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902267636
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/08/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2820 N BELT LINE RD
Provider Second Line Business Mailing Address:
STE 200
Provider Business Mailing Address City Name:
SUNNYVALE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75182-9388
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-882-8008
Provider Business Mailing Address Fax Number:
972-882-8004

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2820 N BELT LINE RD
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
SUNNYVALE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75182-9388
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-882-8008
Provider Business Practice Location Address Fax Number:
972-882-8004
Provider Enumeration Date:
03/08/2016

Additional Information

Authorized Official

Authorized Official Last Name:
PREECE
Authorized Official First Name:
ANYA
Authorized Official Middle Name:
NICOLE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
972-882-8008

Provider Taxonomy Codes

  • Taxonomy code: 1223P0221X , with the licence number:  30844 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1275977233 . This is a "NPI TYPE 1" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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