HEARTLAND MIRROR LAKE DENTISTRY PLLC (NPI# 1558858704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558858704 |
| Entity Type | Organization |
| Organization Name | HEARTLAND MIRROR LAKE DENTISTRY PLLC |
| Practice Address |
2049 Sunnybrook Dr Heartland TX 75126-1270 |
| Practice Telephone | 9722004311 |
| Mailing Telephone | 9722004311 |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2018-04-13 |
| Authorized Official Name | JUSTIN HUMPHRIES (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 9722004311 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
29699 | TX | Ambulatory Health Care Facilities |
| Street Address |
2049 SUNNYBROOK DR |
| City | HEARTLAND |
| State | TX |
| Zip Code | 75126-1270 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083215339 | Stuart Frey | Pharmacist | 802 East Us Hwy 80, Forney, Forney, TEXAS 75126 | 2020-11-03 |
| 1689209975 | Steffani Wooley | Counselor | 106 S. Bois D'arc St., Forney, TX 75126 | 2020-03-06 |
| 1578123402 | Carrie Viola Phillips | Clinical Nurse Specialist | 9478 Homestead Ln., Forney, TX 75126 | 2019-06-13 |
| 1801451901 | Interventional Partners LLC | Podiatrist | 124 East Hwy 80, Ste. 104, Forney, TX 75126 | 2019-05-03 |
| 1881164937 | Precision Sports Physical Therapy | Physical Therapist | 757 E Highway 80, Suite 160, Forney, TX 75126 | 2018-12-03 |
| 1336621374 | Grace Nkolika Ilonuba | Registered Nurse | 1518 Wheatley Way, Forney, TX 75126 | 2018-09-06 |
| 1497235691 | Tanya Jean Antonisse-irwin | Speech-Language Pathologist | 1023 Kimbro Drive, Forney, TX 75126 | 2018-08-16 |
| 1912490491 | Rachel Caroline Casebolt | Counselor | 112 S Bois D Arc St, Forney, TX 75126 | 2018-06-11 |
| 1730676735 | Forney Mirror Lake Dentistry Pllc | Clinic/Center | 845 N. Fm 548, Suite 150, Forney, TX 75126 | 2018-04-16 |
| 1316449366 | Don A Hunt-ford Jr. | Day Training, Developmentally Disabled Services | 2016 Angel Way, Forney, TN 75126 | 2018-03-06 |
| Find all providers in zip 75126 | ||||
| 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 | ||||
Please comment or provide details below to improve the information on HEARTLAND MIRROR LAKE DENTISTRY PLLC.
| 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.