Provider Demographics
NPI:1639284805
Name:NECKER, DAN ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:ALAN
Last Name:NECKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 HEDGEBROOK WAY
Mailing Address - Street 2:
Mailing Address - City:THE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78738-1319
Mailing Address - Country:US
Mailing Address - Phone:512-261-4676
Mailing Address - Fax:
Practice Address - Street 1:2719 E 7TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-3907
Practice Address - Country:US
Practice Address - Phone:512-473-8444
Practice Address - Fax:512-473-2025
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX144261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX009623201Medicaid