MEDICARE: DR. ANDREW W. RANDALL DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	19682	TX

General Provider Information

NPI Number	:	1023031606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW W. RANDALL DDS

Provider Business Mailing Address
First Line	:	6033 SHERRY LANE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75225
Country	:	US
Telephone Number	:	214-718-8899
Fax Number	:

Provider Business Practice Location Address
First Line	:	6033 SHERRY LN.
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75225
Country	:	US
Telephone Number	:	214-750-4901
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	02/19/2026

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