DR. SPENCER MACK (NPI# 1336505635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336505635 |
| Entity Type | Individual |
| Full Name | DR. SPENCER MACK |
| Practice Address |
1405 Judson Rd Longview TX 75601-3918 |
| Practice Telephone | 9032127737 |
| Mailing Telephone | 9032127737 |
| Enumeration Date | 2016-01-04 |
| Last Update Date | 2020-11-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
30007 | TX | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992076384 | Spencer G Mack | Specialist/Technologist | 800 W University Pkwy, Orem, UT 84058-6703 | 2012-01-18 |
| Street Address |
1405 JUDSON RD |
| City | LONGVIEW |
| State | TX |
| Zip Code | 75601-3918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942699087 | Andrew Hansen | Dentist | 1405 Judson Rd, Longview, TX 75601-3918 | 2015-01-13 |
| 1033628920 | Mack and Hansen Orthodontics, Pllc | Clinic/Center | 1405 Judson Rd, Longview, TX 75601-3918 | 2017-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992351076 | Stebbins Hospice LLC | Hospice Care, Community Based | 600-602 E. Whaley, Longview, TX 75601 | 2019-08-14 |
| 1720437692 | J.l. Miguez, Inc. | Hearing Aid Equipment | 822 N 4th Street, Longview, TX 75601 | 2016-06-10 |
| 1801244090 | Voyage Medical Solutions, LLC | Durable Medical Equipment & Medical Supplies | 111 W Tyler St, Longview, TX 75601 | 2016-05-27 |
| 1134504426 | Siobain Kay Rogers | Nurse Practitioner | 703 E Marshall Ave Ste 4003, Longview, TX 75601 | 2015-07-28 |
| 1669882882 | Snehal Shrivastava | Internal Medicine | 1402 N 4th St Ste 300, Longview, TX 75601 | 2014-04-28 |
| 1679824221 | Jennifer Ruth Williams | Occupational Therapist | 110 E Tyler St, Longview, TX 75601 | 2012-09-23 |
| 1548525603 | Candice Renee Ramos | Social Worker | 950 N Sixth St, Longview, TX 75601 | 2012-07-05 |
| 1497082747 | Jarett S Harkness | Pharmacist | 511 E. Marshall Avenue, Longview, TX 75601 | 2009-11-06 |
| 1407086333 | Udeme Ekpenyong | Pediatrics | 818 N. 4th St., Longview, TX 75601 | 2009-07-27 |
| 1386823359 | Assisted Living Concepts Inc | Assisted Living Facility | 2104 Alpine Road, Longview, TX 75601 | 2007-10-26 |
| Find all providers in zip 75601 | ||||
| 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 |
|---|---|---|---|---|
| 1942699087 | Andrew Hansen | Dentist | 1405 Judson Rd, Longview, TX 75601-3918 | 2015-01-13 |
| 1205160843 | Adam Clark Spencer | Dentist | 2904 N. 4th St, Suite 107, Longview, TX 75605 | 2009-09-30 |
| 1831320993 | Peter C Wagner Dmd Ps | Dentist | 855 Broadway, Longview, WA 98632 | 2009-08-06 |
| 1326262130 | Carroll L Sherman | Dentist | 3006 H G Moseley Pkwy, Longview, TX 75605-2948 | 2007-04-12 |
| 1063533354 | Patrick Briscoe | Dentist | 3006 H G Mosley Pkwy, Longview, TX 75605-2948 | 2007-04-03 |
| 1366566291 | Michael Woodward Scott | Dentist | 2830 Bill Owens Pkwy, Longview, TX 75605-2102 | 2007-03-17 |
| 1659432565 | Lauren Cai | Dentist | 870 12th Ave, Longview, WA 98632-2404 | 2006-12-13 |
| 1427168541 | Sherman Sherman & Briscoe Orthodontics | Dentist | 3006 Hg Mosley, Longview, TX 75605-2948 | 2006-08-30 |
| 1134129224 | David Asbjorn Eikrem | Dentist | 855 11th Ave, Ste A, Longview, WA 98632 | 2005-07-29 |
| 1477073310 | Sherif Elbarnashawy | Dentist | 2539 Judson Rd, Longview, TX 75605-4643 | 2017-06-21 |
| Find all providers in LONGVIEW | ||||
Please comment or provide details below to improve the information on DR. SPENCER MACK.
| 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.