WALNUT RIDGE ORTHODONTICS (NPI# 1629331608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629331608 |
| Entity Type | Organization |
| Organization Name | WALNUT RIDGE ORTHODONTICS |
| Practice Address |
3807 E Broad St Ste 101 Mansfield TX 76063-5623 |
| Practice Telephone | 6823002300 |
| Practice Fax Number | 6822921373 |
| Mailing Telephone | 6823002300 |
| Mailing Fax Number | 6822921373 |
| Enumeration Date | 2012-06-24 |
| Last Update Date | 2012-06-24 |
| Authorized Official Name | DR. STEVEN MACHICEK (ORTHODONTIST) |
| Authorized Official Telephone | 6823002300 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
24724 | TX | Dental Providers |
| Street Address |
3807 E BROAD ST STE 101 |
| City | MANSFIELD |
| State | TX |
| Zip Code | 76063-5623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902035835 | Steven Lee Machicek | Dentist | 3807 E Broad St Ste 101, Mansfield, TX 76063-5623 | 2009-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316558349 | Lindsey Vandyke, D.o. Pllc | Internal Medicine | 3150 E Broad Street, Ste 100, Mansfield, TX 76063 | 2020-08-13 |
| 1942819867 | Jennifer Que Chau Nguyen | Pharmacist | 980 U.S. 287 Frontage Rd #287, Mansfield, TX 76063 | 2020-07-27 |
| 1194346890 | Ana Maria Gonzalez | Dentist | 1600 Us Highway 287, Suite 102, Mansfield, TX 76063 | 2020-05-04 |
| 1245869080 | Stateserv Medical of Texas, LLC | Durable Medical Equipment & Medical Supplies | 7941 Rodeo Trail, Mansfield, TX 76063 | 2020-04-03 |
| 1649802232 | Mary Puanani Kamai | Nurse Practitioner | 1301 E. Debbie Lane, Suite 102 #1405, Mansfield, TX 76063 | 2020-02-11 |
| 1770123028 | Gladys Vera Nfodzo | Nurse Practitioner | 901 W. Broad St, Mansfield, TX 76063 | 2020-01-14 |
| 1669011300 | Alexa Smith | Nurse Practitioner | 2800 E Broad St #304, Mansfield, TX 76063 | 2019-12-28 |
| 1477190437 | Mel Rockwall LLC | Optometrist | 1701 East Broad Street, Ste 109, Mansfield, TX 76063 | 2019-12-09 |
| 1376185512 | Daniel Max & Marcandrea LLC | Optometrist | 1701 East Broad St., Ste 109, Mansfield, TX 76063 | 2019-10-09 |
| 1861046385 | Lacey Eaton | Counselor | 805 Killian Dr, Mansfield, TX 76063 | 2019-08-01 |
| Find all providers in zip 76063 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487183265 | Se Ortho Mansfield, Inc. | Dentist | 100 Copeland Dr Ste 9, Mansfield, MA 02048-1245 | 2017-06-06 |
| 1588116305 | Shelley R. Tardy | Dentist | 1220 Highway 287 N, Mansfield, TX 76063-4804 | 2016-10-27 |
| 1902035835 | Steven Lee Machicek | Dentist | 3807 E Broad St Ste 101, Mansfield, TX 76063-5623 | 2009-07-13 |
| 1982895454 | David Blackwell | Dentist | 1788 Highway 157 N, Ste 105, Mansfield, TX 76063-3989 | 2007-08-08 |
| 1750508081 | Walter Charles Buchsieb II | Dentist | 2184 W 4th St, Mansfield, OH 44906-1203 | 2007-04-19 |
| 1770633257 | Island Orthodontics | Dentist | 800 Matlock Rd, Mansfield, TX 76063-9126 | 2007-01-10 |
| 1376606673 | Rick Herrmann Orthodontics Pa | Dentist | 2300 Matlock Rd, Suite 28, Mansfield, TX 76063-5019 | 2006-12-18 |
| 1770680829 | Tardy Orthodontics PC | Dentist | 1220 Hwy 287 North, Mansfield, TX 76063 | 2006-09-20 |
| 1144833286 | Williams Dental Wellness Pllc | Dentist | 1560 Highway 287 N Ste 100, Mansfield, TX 76063-8824 | 2020-08-28 |
| 1063077410 | Calvin Tardy | Dentist | 1220 Highway 287 N, Mansfield, TX 76063-4804 | 2019-05-01 |
| Find all providers in MANSFIELD | ||||
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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.