DENTATE (NPI# 1487623104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487623104 |
| Entity Type | Organization |
| Organization Name | DENTATE |
| Other Organization Name | ORAL & FACIAL SURGERY GROUP |
| Practice Address |
508 Russell Blvd Nacogdoches TX 75965-1244 |
| Practice Telephone | 9365691111 |
| Practice Fax Number | 9365640808 |
| Mailing Telephone | 9365691111 |
| Mailing Fax Number | 9365640808 |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2018-10-11 |
| Authorized Official Name | DR. GREGORY SCOTT TATE (OWNER) |
| Authorized Official Telephone | 9365691111 |
| Authorized Official Credential | MD, DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
TX | Dental Providers |
| Other Name | Type Code |
|---|---|
| Oral & Facial Surgery Group | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | DENTATE EQUIPMENT LEASING, LLC | 1020 Monte Verde Drive, Arcadia, CA 91007 |
| System for Award Management (SAM) Entities | DENTATECH LLC | 7433 N Chicago Ave, Portland, OR 97203-3712 |
| Oregon Corporations, Companies and Business Names | DENTATECH LLC | 7433 N Chicago Ave, Portland, OR 97203 |
| Street Address |
508 RUSSELL BLVD |
| City | NACOGDOCHES |
| State | TX |
| Zip Code | 75965-1244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477522266 | Rick Lee Hurst | Dentist | 508 Russell Blvd, Nacogdoches, TX 75965-1244 | 2006-03-15 |
| 1861461121 | Greg S Tate | Dentist | 508 Russell Blvd, Nacogdoches, TX 75965-1244 | 2006-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649839135 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3824 N University Drive, Suite 103, Nacogdoches, TX 75965 | 2019-06-10 |
| 1518520493 | Billy Jobe | Pharmacist | 917 East Austin, Nacogdoches, TX 75965 | 2019-04-17 |
| 1295217610 | Sarah Ponder | Registered Nurse | 625 Woodway Lane, Nacogdoches, TX 75965 | 2018-09-01 |
| 1083107684 | Aakash Deep Gupta | Dentist | 4610 North St Ste 101b, Nacogdoches, TX 75965 | 2018-06-08 |
| 1679097455 | Emily Morris Taravella | Counselor | 3524 Ne Stallings Drive, Nacogdoches, TX 75965 | 2017-08-02 |
| 1457809949 | Kassey Osborn | Nurse Practitioner | 4920 Ne Stallings Dr., Nacogdoches Medical Center, Nacogdoches, TX 75965 | 2016-09-14 |
| 1629426747 | Lisa Greathouse | Technician, Other | 500 Chincapin, Westville, OK 75965 | 2016-05-31 |
| 1457741704 | Nuch of Texas | Pediatrics | 1305 North Street, Nacogdoches, TX 75965 | 2015-01-26 |
| 1730506031 | Benjamin Patrick Thompson | Obstetrics & Gynecology | 4800 Ne Stallings Dr Ste 106, Nacogdoches, TX 75965 | 2014-03-25 |
| 1255761813 | Kallie Krawietz | Counselor | 2214 N Pecan Street, Nacogdoches, TX 75965 | 2013-11-19 |
| Find all providers in zip 75965 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467624973 | Brett Mccann Shirley | Dentist | 4800 Ne Stallings Dr Ste 113, Nacogdoches, TX 75965 | 2008-03-25 |
| 1477522266 | Rick Lee Hurst | Dentist | 508 Russell Blvd, Nacogdoches, TX 75965-1244 | 2006-03-15 |
| 1891264024 | Brett Shirley Dds Md Pllc | Dentist | 4800 Ne Stallings Dr Ste 113, Nacogdoches, TX 75965-1250 | 2018-11-16 |
| 1659539708 | Sidney J. Fowler, D.d.s. | Dentist | 1023 N Mound St, Suite D, Nacogdoches, TX 75961-4491 | 2008-05-27 |
| 1861461121 | Greg S Tate | Dentist | 508 Russell Blvd, Nacogdoches, TX 75965-1244 | 2006-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720337 | Texas Wisdom Teeth Specialists | Dentist | 8409 W Cleburne Rd, Fort Worth, TX 76123-1421 | 2020-11-04 |
| 1932716859 | Gentle Dentistry Inc | Dentist | 1810 S Bowen Rd Ste A, Arlington, TX 76013-3340 | 2020-09-24 |
| 1568080497 | San Antonio Wisdom Teeth, Pllc | Dentist | 13535 Hausman Pass #102-a, San Antonio, TX 78249 | 2020-07-07 |
| 1033733365 | Ernesto Carmona Jr Dds PC | Dentist | 10125a Lake Creek Pkwy, Austin, TX 78729-1711 | 2020-06-02 |
| 1437779691 | Kendall Implant and Oral Surgery | Dentist | 109 Falls Ct Ste 700, Boerne, TX 78006-2984 | 2020-04-17 |
| 1285273847 | Cardenas Dental Implants and Oral Surgery | Dentist | 5460 Paredes Line Rd Ste 197a, Brownsville, TX 78526-9742 | 2019-12-31 |
| 1770134876 | Red River Oral Surgery | Dentist | 4616 Highway 75, Suite 201, Denison, TX 75020 | 2019-09-20 |
| 1316594120 | Mona Stone Dds LLC | Dentist | 4863 Allencrest Ln, Dallas, TX 75244-7710 | 2019-08-26 |
| 1821640822 | Guillen Rivera Oral and Maxillofacial Surgery Pllc | Dentist | 7100 Westwind Dr Ste 110-115, El Paso, TX 79912-1786 | 2019-07-10 |
| 1073173274 | Woodlands Oral & Maxillofacial Surgery | Dentist | 4850 W. Panther Creek Drive Suite 106, The Woodlands, TX 77381 | 2019-06-19 |
| Find all providers with the same taxonomy | ||||
| City | NACOGDOCHES |
| Zip Code | 75965 |
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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.