DENTISTRY OF TEXAS, PC (NPI# 1508189879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508189879 |
| Entity Type | Organization |
| Organization Name | DENTISTRY OF TEXAS, PC |
| Practice Address |
1932 E Southeast Loop 323 Tyler TX 75701-8337 |
| Mailing Address |
400 Galleria Pkwy Se Ste 800 Attn; Chris Woods Atlanta GA 30339-6413 |
| Practice Telephone | 7709169000 |
| Mailing Telephone | 7709165028 |
| Mailing Fax Number | 6782477858 |
| Enumeration Date | 2010-03-01 |
| Last Update Date | 2010-03-01 |
| Authorized Official Name | DR. PAUL O WALKER (PRESIDENT) |
| Authorized Official Telephone | 7709165028 |
| Authorized Official Credential | DDS, MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Street Address |
1932 E SOUTHEAST LOOP 323 |
| City | TYLER |
| State | TX |
| Zip Code | 75701-8337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578745147 | Kori D Robinson | Dentist | 1932 E Southeast Loop 323, Tyler, TX 75701-8337 | 2007-12-05 |
| 1740622505 | Radhika Dilip Lonkar | Dentist | 1932 E Southeast Loop 323, Tyler, TX 75701-8337 | 2013-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083842629 | Pediatric Dentistry of Tyler, Pllc | Dentist | 3607 Old Jacksonville Rd, Tyler, TX 75701-8512 | 2009-06-22 |
| 1083707970 | John David Carter | Dentist | 3607 Old Jacksonville Hwy, Tyler, TX 75701 | 2006-10-02 |
| 1578502878 | Kent B Boozer | Dentist | 5540 Old Jacksonville Hwy, Tyler, TX 75703-1633 | 2006-06-05 |
| 1699281782 | Ikids Pediatric Dentistry Tyler, Pllc | Dentist | 3607 Old Jacksonville Rd, Tyler, TX 75701 | 2017-12-27 |
| 1740622505 | Radhika Dilip Lonkar | Dentist | 1932 E Southeast Loop 323, Tyler, TX 75701-8337 | 2013-07-22 |
| 1033411962 | Culberson R. Boren, D.d.s., P.a. | Dentist | 7916 S Broadway Ave, Ste 150, Tyler, TX 75703-5274 | 2010-11-29 |
| 1467689307 | St Paul Children's Medical Corporation | Dentist | 132 S Horace Ave, Tyler, TX 75702-6159 | 2009-06-18 |
| 1508046129 | Kent B Boozer Dds Pa | Dentist | 5540 Old Jacksonville Hwy, Tyler, TX 75703-3378 | 2007-11-12 |
| 1275713976 | Community Health Clinics of Northeast Texas | Dentist | 928 N Glenwood Blvd, Tyler, TX 75702-5055 | 2007-11-09 |
| 1497837587 | Culberson Reeves Boren | Dentist | 7916 S Broadway Ave, Ste 150, Tyler, TX 75703-5274 | 2006-10-19 |
| Find all providers in TYLER | ||||
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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.