EAGLE MOUNTAIN PEDIATRIC DENTISTRY (NPI# 1669080487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669080487 |
| Entity Type | Organization |
| Organization Name | EAGLE MOUNTAIN PEDIATRIC DENTISTRY |
| Practice Address |
705 W Bailey Boswell Rd Saginaw TX 76179-1020 |
| Mailing Address |
3575 Lone Star Cir Ste 310 Fort Worth TX 76177-8908 |
| Practice Telephone | 8175761600 |
| Mailing Telephone | 8173506500 |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2020-07-17 |
| Authorized Official Name | JEREMY LUSTIG (CEO) |
| Authorized Official Telephone | 2143350862 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Street Address |
705 W BAILEY BOSWELL RD |
| City | SAGINAW |
| State | TX |
| Zip Code | 76179-1020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477704336 | Janene Sperandeo | Dentist | 705 W Bailey Boswell Rd, Saginaw, TX 76179-1020 | 2008-10-08 |
| 1952749814 | Chelsea Nicole Felton | Chiropractor | 705 W Bailey Boswell Rd, 200, Saginaw, TX 76179-1020 | 2013-06-12 |
| 1700140787 | Nicole M Minatrea | Chiropractor | 705 W Bailey Boswell Rd, Ste 200, Saginaw, TX 76179-1020 | 2012-06-25 |
| 1346560489 | Grill Repair, P.a. | Dentist | 705 W Bailey Boswell Rd, Saginaw, TX 76179-1020 | 2010-06-10 |
| 1538483466 | Chiropractic & Rehab Centers, Inc | Chiropractor | 705 W Bailey Boswell Rd, Saginaw, TX 76179-1020 | 2010-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992347215 | Katherine M Wright | Behavior Technician | 5804 Boat Club Road, Fort Worth, TX 76179 | 2019-10-09 |
| 1982245775 | Makaylin Rene Mayes | Behavior Technician | 5804 Boat Club Rd, Fort Worth, TX 76179 | 2019-10-02 |
| 1881246049 | Renkuntla Pllc | Dentist | 240 S Saginaw Blvd, Saginaw, TX 76179 | 2019-07-09 |
| 1376062026 | Michele Ann Taylor | Massage Therapist | 6352 Stone Lake Drive, Fort Worth, TX 76179 | 2017-09-13 |
| 1649796921 | Amanda Williams | Music Therapist | 6212 Rocky Point Trail, Lake Worth, TX 76179 | 2017-08-17 |
| 1912437922 | Dentists of Eagle Mountain, PC | Dentist | 4624 West Bailey Boswell Road, Suite 200, Fort Worth, TX 76179 | 2017-06-13 |
| 1982059283 | 11th Hour Counseling | Social Worker | 949 Sherry Ln, Saginaw, TX 76179 | 2016-04-25 |
| 1114307212 | Stephanie Lee Beavers | Chiropractor | 524 Buckstone Dr., Saginaw, TX 76179 | 2015-06-03 |
| 1760885297 | Kali Nagabalaji | Pharmacy | 200 W J Boaz Rd, Ste 100, Saginaw, TX 76179 | 2014-09-29 |
| 1750794541 | Julie Norwood | Dentist | 1453 N. Saginaw Blvd., Suite 150, Saginaw, TX 76179 | 2014-06-09 |
| Find all providers in zip 76179 | ||||
| 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 |
|---|---|---|---|---|
| 1407322548 | Great Lakes Bay Pediatric Dentistry, Plc | Dentist | 5605 Colony Dr N Ste 2, Saginaw, MI 48638-7187 | 2018-10-16 |
| 1598721334 | William James Lamb | Dentist | 5605 Colony Dr N, Saginaw, MI 48638-7187 | 2006-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326647454 | Memorial Dentistry for Kids Pllc | Dentist | 14090 Memorial Dr, Houston, TX 77079-6848 | 2020-10-20 |
| 1497362651 | Munal Dental Pllc | Dentist | 2921 N Fm 1417 Ste 100, Sherman, TX 75092-3559 | 2020-09-30 |
| 1467069880 | Unique Kids Pediatric Dentistry, Pllc | Dentist | 22118 Market Place Dr Ste 500, New Caney, TX 77357-2165 | 2020-09-29 |
| 1104438092 | Sarah Al Kukash | Dentist | 2536 Amherst St Ste A, Houston, TX 77005-3207 | 2020-08-20 |
| 1295344679 | Bulverde Dental Specialist Pllc | Dentist | 22103 Bulverde Rd Ste 108, San Antonio, TX 78259-1855 | 2020-07-30 |
| 1174132559 | Previcare, Pllc | Dentist | 2006 W Campbell Rd Ste 300, Garland, TX 75044-2315 | 2020-07-30 |
| 1386252088 | Saba Saleem Tareen | Dentist | 1503 Royal Ln, Colleyville, TX 76034-5585 | 2020-07-19 |
| 1306454178 | Susan Roberts Pediatric Dentistry Pllc | Dentist | 5411 Basswood Blvd Ste 201, Fort Worth, TX 76137-4479 | 2020-07-17 |
| 1316564990 | Ikids Pediatric Dentistry Lakewood, Pllc | Dentist | 2011 Abrams Parkway, Dallas, TX 75214 | 2020-06-30 |
| 1316563497 | Woodlands Pediatric Dentistry PC | Dentist | 4850 W Panther Creek Dr Ste 102, The Woodlands, TX 77381-3595 | 2020-06-24 |
| 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.