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1518980994 NPI number — EDWARD WILLIAM NESTOR D.D.S., P.A.

NPI Number: 1518980994
Health Care Provider/Practitioner: EDWARD WILLIAM NESTOR D.D.S., P.A.

Information about “1518980994” NPI (EDWARD WILLIAM NESTOR D.D.S., P.A.) exists in 1518980994 in HTML format HTML  |  1518980994 in plain Text format TXT  |  1518980994 in PDF (Portable Document Format) PDF  |  1518980994 in an XML format XML  formats.

NPI Number : 1518980994 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1518980994",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "NESTOR",
    "FirstName": "EDWARD",
    "MiddleName": "WILLIAM",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "D.D.S., P.A.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "NESTOR",
    "OtherFirstName": "EDWARD",
    "OtherMiddleName": "WILLIAM",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "DDS",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "PO BOX 2629",
    "SecondLineMailingAddress": "106 W. MAIN ST.",
    "MailingAddressCityName": "TRINITY",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75862-2629",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "936-594-2076",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "106 W. MAIN ST.",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TRINITY",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75862-2629",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "936-594-2076",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/26/2006",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1223G0001X",
        "TaxonomyName": "General Practice Dentistry",
        "LicenseNumber": "11611",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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