NORTH MESA DENTAL, PC (NPI# 1437458874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437458874 |
| Entity Type | Organization |
| Organization Name | NORTH MESA DENTAL, PC |
| Other Organization Name | GOODLAND DENTISTRY |
| Practice Address |
3864 Hwy 64 West Tyler TX 75704 |
| Mailing Address |
1090 Northchase Pkwy Se Ste 150 Marietta GA 30067-6407 |
| Practice Telephone | 6789045665 |
| Practice Fax Number | 6789045666 |
| Mailing Telephone | 7709165028 |
| Mailing Fax Number | 6782477858 |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2019-06-17 |
| Authorized Official Name | DR. DALE MAYFIELD (PRESIDENT) |
| Authorized Official Telephone | 7709165036 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers | ||
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers | ||
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Goodland Dentistry | Doing Business As Name - Organization |
| Kool Smiles | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376842096 | North Mesa Dental, PC | Dentist | 3840 Aldine Mail Rd, Houston, TX 77039-4644 | 2011-03-21 |
| 1174822118 | North Mesa Dental, PC | Dentist | 1601 Walton Dr, Waco, TX 76705-2468 | 2011-03-16 |
| 1003122177 | North Mesa Dental, PC | Dentist | 4403 Sherwood Way, San Angelo, TX 76901-5616 | 2010-08-26 |
| 1245560689 | North Mesa Dental, PC | Dentist | 710 Estes Dr Ste 105, Longview, TX 75602-6120 | 2010-01-07 |
| 1760712335 | North Mesa Dental, PC | Dentist | 2903 50th St, Lubbock, TX 79413-4323 | 2010-01-05 |
| 1003142597 | North Mesa Dental, PC | Dentist | 6910 N Mesa St Ste C, El Paso, TX 79912-4446 | 2009-10-19 |
| 1568618759 | North Mesa Dental, PC | Dentist | 1613 N West County Rd, Suite C, Odessa, TX 79763-2917 | 2008-08-07 |
| 1730335928 | North Mesa Dental, PC | Dentist | 3063 S. John Redditt Drive, Lufkin, TX 75904 | 2008-08-07 |
| 1659548774 | North Mesa Dental, PC | Dentist | 5130 Fairbanks Dr, El Paso, TX 79924-3813 | 2008-05-08 |
| 1033380142 | North Mesa Dental, PC | Dentist | 4754 S 14th St, Abilene, TX 79605-4733 | 2008-03-17 |
| Street Address |
3864 HWY 64 WEST |
| City | TYLER |
| State | TX |
| Zip Code | 75704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194325415 | Rupal R Patel | Pharmacist | 3820 Tx 64, Tyler, TX 75704 | 2020-10-27 |
| 1932757945 | Gracelyn Hernandez Kuester | Technician | 14320 Country Road 420, Tyler, TX 75704 | 2019-09-03 |
| 1033770227 | Rajamanoj Kondaveeti | Dentist | 3873 Tx-64, Tyler, TX 75704 | 2019-06-27 |
| 1063070209 | Susan Michele Whitaker | Counselor | The Beginning, 114 Jordan Plaza Blvd Suite 302, Tyler, TX 75704 | 2019-06-03 |
| 1649836768 | Tyla Sherrie' Tarrant | Licensed Vocational Nurse | 3050 Cr 427, #502, Tyler, TX 75704 | 2019-05-14 |
| 1093025751 | Zana Elliot Enterprises LLC | Nurse Practitioner | 12751 Westbrook Dr, Tyler, TX 75704 | 2010-10-15 |
| 1710036454 | Tammy Jimenez | Dietitian, Registered | 5555 W. Twin Lakes Dr., Tyler, TX 75704 | 2007-01-10 |
| 1063023935 | Shanika Lanell Grant | Licensed Vocational Nurse | 134 Patton Ln, Tyler, TX 75704-2004 | 2020-08-13 |
| 1194342410 | Shanequia Dianne Flowers | Licensed Vocational Nurse | 404 Lemay Dr, Tyler, TX 75704-2031 | 2020-07-02 |
| 1396774071 | Omnicare Pharmacy of Texas 2, Lp | Pharmacy | 105 Jordan Plaza Blvd, Tyler, TX 75704-2048 | 2006-07-03 |
| Find all providers in zip 75704 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093329534 | Professional Dental Alliance of Tx 43004 Pllc | Dentist | 212 Old Grande Blvd Ste B224, Tyler, TX 75703-4277 | 2020-09-02 |
| 1679183446 | Valerie Marie Cano | Dentist | 7223 Crosswater, Tyler, TX 75703-0719 | 2020-08-05 |
| 1033770227 | Rajamanoj Kondaveeti | Dentist | 3873 Tx-64, Tyler, TX 75704 | 2019-06-27 |
| 1538720016 | Trevor Justin Wortley | Dentist | 8942 S Broadway Ave Ste 128, Tyler, TX 75703-5443 | 2019-06-25 |
| 1710473681 | Justin Taylor Ross | Dentist | 8938 S Broadway Ave Ste 380, Tyler, TX 75703 | 2018-07-03 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1457843450 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 8938 South Broadway, Ste 480, Tyler, TX 75703 | 2018-06-05 |
| 1992217947 | Charles Cox IIi | Dentist | 1327 S Baxter Ave, Tyler, TX 75701-3404 | 2017-10-31 |
| 1326559022 | Blu Dental Group PC | Dentist | 3975 Old Jacksonville Rd, Tyler, TX 75701-8519 | 2017-10-20 |
| 1629598586 | Kunduru Dental Pllc | Dentist | 4164 S Broadway Ave, Tyler, TX 75701-8719 | 2017-06-22 |
| Find all providers in TYLER | ||||
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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.