RESTORE DENTAL PLLC (NPI# 1104215367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104215367 |
| Entity Type | Organization |
| Organization Name | RESTORE DENTAL PLLC |
| Practice Address |
3108 W State Highway 22 Corsicana TX 75110-2435 |
| Practice Telephone | 9032578815 |
| Practice Fax Number | 9039004184 |
| Mailing Telephone | 9032578815 |
| Mailing Fax Number | 9039004184 |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2016-01-14 |
| Authorized Official Name | DR. MAHESH B. GONDI (PRESIDENT) |
| Authorized Official Telephone | 9032578815 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
22213 | TX | Dental Providers |
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
22213 | TX | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | NPI | 1306909080 | 01 |
| Street Address |
3108 W STATE HIGHWAY 22 |
| City | CORSICANA |
| State | TX |
| Zip Code | 75110-2435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033294319 | Network Provider Associates | Dentist | 3108 W State Highway 22, Corsicana, TX 75110-2435 | 2006-10-26 |
| 1154541134 | Anna Tomlinson | Dental Hygienist | 3108 W State Highway 22, Corsicana, TX 75110-2435 | 2007-05-01 |
| 1245454610 | James Adams | Dentist | 3108 W State Highway 22, Corsicana, TX 75110-2435 | 2007-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881161750 | Christy Michelle Childers | Licensed Vocational Nurse | 118 S 31st Street, Corsicana, TX 75110 | 2018-10-30 |
| 1609355825 | Vi Truong | Pharmacist | 201 S 15th, Corsicana, TX 75110 | 2018-08-08 |
| 1780174383 | Nanine Marie Dickson | Counselor | 1522 N. 24th Corsicana, Tx, Corsicana, Tx, TX 75110 | 2018-05-18 |
| 1245776897 | Family and Child Guidance Center | Counselor | 317 North 12th, Suite 1, Corsicana, TX 75110 | 2017-01-06 |
| 1033567862 | Matthew Oakden | Physical Therapist | 3201 West Tx-22, Corsicana, TX 75110 | 2016-06-02 |
| 1346682572 | Byron E. Advent | Optometrist | 105 W. 7th Ave, Suite 800, Corsicana, TX 75110 | 2013-07-30 |
| 1275971533 | Corsicana Cancer Center | Radiology | 306 Hospital Dr., Corsicana, TX 75110 | 2013-06-10 |
| 1528361862 | Pm Management - Corsicana Nc IIi LLC | Skilled Nursing Facility | 3300 West 2nd Ave., Corsicana, TX 75110 | 2010-12-08 |
| 1245551423 | Care-a-lot Home Health Agency, Inc | Home Health | 1725 N. Beaton, Corsicana, TX 75110 | 2010-06-22 |
| 1063735561 | Tina Marie Hill | Physical Medicine & Rehabilitation | 3301 W. Park Row, Corsicana, TX 75110 | 2010-03-11 |
| Find all providers in zip 75110 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467053587 | David Cheng, Pllc | Clinic/Center | 1708 Spring Green Blvd Ste 195, Katy, TX 77494-7462 | 2020-11-04 |
| 1710587431 | Mysa Dental Pllc | Clinic/Center | 13762 Potranco Rd, Suite 400, San Antonio, TX 78253 | 2020-10-30 |
| 1952901753 | Hq Dental Design | Clinic/Center | 3011 Dawn Dr Ste 105, Georgetown, TX 78628-2827 | 2020-10-29 |
| 1821698788 | All About Smiles Pllc | Clinic/Center | 6420 N Macarthur Blvd Ste 120, Irving, TX 75039-2838 | 2020-10-29 |
| 1659971901 | Qs Dental Partners Pllc | Clinic/Center | 7109 Katy Gaston Road, Suite 400, Richmond, TX 77406 | 2020-10-27 |
| 1154920023 | Deja Opusunju Dmd Pllc | Clinic/Center | 25031 Westheimer Pkwy Ste 200, Katy, TX 77494-7317 | 2020-10-22 |
| 1639776040 | Usck Pllc | Clinic/Center | 7598 N Mesa St Ste 208, El Paso, TX 79912-3521 | 2020-10-08 |
| 1962009373 | Woodforest Dental Loft | Clinic/Center | 2300 Woodforest Pkwy N Ste 700, Montgomery, TX 77316-6503 | 2020-10-08 |
| 1932706173 | Crossway Dental Care Pllc | Clinic/Center | 16616 San Pedro Ave, San Antonio, TX 78232-2223 | 2020-10-01 |
| 1184230302 | Mi Dentista | Clinic/Center | 3101 W Davis St, Dallas, TX 75211-2921 | 2020-09-22 |
| Find all providers with the same taxonomy | ||||
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| 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.