LAKE KIOWA FAMILY DENTAL, PLLC (NPI# 1528423266) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528423266 |
| Entity Type | Organization |
| Organization Name | LAKE KIOWA FAMILY DENTAL, PLLC |
| Practice Address |
100 Kiowa Dr W Suite 200 Lake Kiowa TX 76240-9584 |
| Practice Telephone | 9406121555 |
| Mailing Telephone | 9406121555 |
| Enumeration Date | 2015-12-23 |
| Last Update Date | 2015-12-23 |
| Authorized Official Name | DR. MATTHEW A BAYNE (DENTIST) |
| Authorized Official Telephone | 9406121555 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
24498 | TX | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | INDIVIDUAL NPI | 1518167915 | 01 |
| Street Address |
100 KIOWA DR W SUITE 200 |
| City | LAKE KIOWA |
| State | TX |
| Zip Code | 76240-9584 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497749147 | Holly Oliveira | Nurse Practitioner | 100 Kiowa Dr W, Suite 103, Lake Kiowa, TX 76240-9584 | 2005-09-08 |
| 1902447352 | Sarah Friedrich | Chiropractor | 100 Kiowa Dr W, Lake Kiowa, TX 76240-9584 | 2019-10-07 |
| 1568729887 | Jami A. Hamilton, Dc, LLC | Chiropractor | 100 Kiowa Dr W, Suite 301, Lake Kiowa, TX 76240-9584 | 2012-04-12 |
| 1962773796 | Jami West | Chiropractor | 100 Kiowa Dr W, Suite 301, Lake Kiowa, TX 76240-9584 | 2012-01-25 |
| 1285612531 | Edward Lewis Emde | Pharmacist | 100 Kiowa Dr W, #104, Lake Kiowa, TX 76240-9506 | 2006-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144886318 | Wesley Partners Senior Living LLC | Assisted Living Facility | 3291 E Broadway, Gainesville, TX 76240 | 2019-05-14 |
| 1699259341 | Justin Edward Rainey | Specialist/Technologist | 308 Dozier Ln, Callisburg, TX 76240 | 2018-09-19 |
| 1598250128 | Stuart Lloyd Smith | Nurse Practitioner | 1820 Oneal St, Gainesville, TX 76240 | 2018-06-26 |
| 1962903385 | Kristin Marie Robinson | Licensed Vocational Nurse | 1802 Cr222, Gainsville, TX 76240 | 2018-02-21 |
| 1730693185 | Kelea Ann Tischler | Pharmacist | 1201 Olive St., Gainsville, TX 76240 | 2017-11-21 |
| 1003285933 | Family Chiropractic & Wellness Center of Gainesville | Chiropractor | 4322 W. Hwy 82, Gainesville, TX 76240 | 2015-09-22 |
| 1104206820 | Emily Springer | Speech-Language Pathologist | 1014 E Highway 82 Unit 209, Gainesville, TX 76240 | 2015-06-08 |
| 1417291717 | Higbee Dialysis LLC | Clinic/Center | 1902 Hospital Blvd Ste D, Gainesville, TX 76240 | 2012-11-27 |
| 1356629679 | Mark Allen Cox | Chiropractor | 4322 W Hwy 82, Gainesville, TX 76240 | 2011-08-03 |
| 1043470180 | North Texas Children's Dentistry, Pllc | Dentist | 321 North Grand Avenue, Gainesville, TX 76240 | 2008-06-12 |
| Find all providers in zip 76240 | ||||
| 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 | ||||
| City | LAKE KIOWA |
| Zip Code | 76240 |
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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.