W. MAIN STREET DENTAL LEWISVILLE, TX, P.C. (NPI# 1023508819) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023508819 |
| Entity Type | Organization |
| Organization Name | W. MAIN STREET DENTAL LEWISVILLE, TX, P.C. |
| Other Organization Name | JUBILEE DENTAL |
| Practice Address |
724 W Main St Ste 316 Lewisville TX 75067 |
| Mailing Address |
1090 Northchase Pkwy Se Ste 150 Marietta GA 30067-6407 |
| Practice Telephone | 4693126201 |
| Practice Fax Number | 4693126202 |
| Mailing Telephone | 7709165036 |
| Mailing Fax Number | 6782854760 |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2018-05-23 |
| Authorized Official Name | DR. DALE MAYFIELD (PRESIDENT) |
| Authorized Official Telephone | 7709165036 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers | ||
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers | ||
| N | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers | ||
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Jubilee Dental | Doing Business As Name - Organization |
| Street Address |
724 W MAIN ST STE 316 |
| City | LEWISVILLE |
| State | TX |
| Zip Code | 75067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437767290 | Dental Depot of Lewisville, Pllc | Dentist | 1260 W Fm 3040, Lewisville, TX 75067 | 2020-07-17 |
| 1548885692 | Guiding Grace LLC | Case Management | 405 State Highway 121, Ste A250, Lewisville, TX 75067 | 2020-06-15 |
| 1548800733 | Dfw Lewisville Emergency Center LLC | Emergency Medicine | 1596 W. Main St., Lewisville, TX 75067 | 2020-01-15 |
| 1386286854 | Rachel Lee Herd | Registered Nurse | 940 W Round Grove Rd Apt 2237, Lewisville, TX 75067 | 2019-10-16 |
| 1437631108 | Rosa Lydia Rodriguez | Massage Therapist | 330 Brook Cove Ln, Lewisville, TX 75067 | 2018-08-29 |
| 1255821286 | Alicia D Wallace | Counselor | 105 Kathryn Dr. Bldg. 3, Ste. D, Lewisville, TX 75067 | 2018-05-15 |
| 1861921116 | Megan Blair Morrison | Dentist | 420 E Round Grove Rd #640, Lewisville, TX 75067 | 2017-06-09 |
| 1508305905 | Schofield Orthodontics Pllc | Dentist | 755 Hwy 121 Byp, A200, Lewisville, TX 75067 | 2017-02-17 |
| 1275080897 | Trinity Counseling | Counselor | 2001 Woven Trail, Lewisville, TX 75067 | 2016-09-01 |
| 1750745840 | Shelley Tedder | Counselor | 2785 Rockbrook Dr. Suite 306, Lewisville, TX 75067 | 2016-04-05 |
| Find all providers in zip 75067 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437767290 | Dental Depot of Lewisville, Pllc | Dentist | 1260 W Fm 3040, Lewisville, TX 75067 | 2020-07-17 |
| 1831716752 | Adriana Chaves Kelton | Dentist | 4730 Windhaven Pkwy Ste 120, Lewisville, TX 75056-6703 | 2020-06-26 |
| 1790347730 | Jessica Artille | Dentist | 4940 State Highway 121 Ste 115, Lewisville, TX 75056-2928 | 2019-06-30 |
| 1225521677 | Mei Ho Corp | Dentist | 1071 W Round Grove Rd Ste 800, Lewisville, TX 75067-7924 | 2018-06-11 |
| 1417445388 | Serene Smiles Dentistry Pllc | Dentist | 951 W Round Grove Rd Ste 300, Lewisville, TX 75067-7902 | 2018-04-26 |
| 1588178263 | Alice Guyue Liu | Dentist | 1800 Justin Rd, Lewisville, TX 75077-2158 | 2017-11-17 |
| 1629597240 | Jason T. Moore, D.d.s. and Adam T. Dorsett, D.d.s., Pa | Dentist | 1341 Lewisville Clemmons Rd, Lewisville, NC 27023-9635 | 2017-09-14 |
| 1861921116 | Megan Blair Morrison | Dentist | 420 E Round Grove Rd #640, Lewisville, TX 75067 | 2017-06-09 |
| 1669928073 | Round Grove Family Dentistry | Dentist | 2325 S Stemmons Fwy, Ste 301, Lewisville, TX 75067-8754 | 2016-08-27 |
| 1306206909 | Arte Dental Lewisville, Pllc | Dentist | 1640 S Business 121, Suite 130, Lewisville, TX 75067 | 2016-02-25 |
| Find all providers in LEWISVILLE | ||||
| City | LEWISVILLE |
| Zip Code | 75067 |
Please comment or provide details below to improve the information on W. MAIN STREET DENTAL LEWISVILLE, TX, P.C..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.