MACK DENTAL (NPI# 1942840004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1942840004 |
Entity Type | Organization |
Organization Name | MACK DENTAL |
Practice Address |
3008 H G Mosley Pkwy Longview TX 75605-2948 |
Practice Telephone | 9032364050 |
Practice Fax Number | 9037534426 |
Mailing Telephone | 9032364050 |
Mailing Fax Number | 9037534426 |
Enumeration Date | 2020-01-07 |
Last Update Date | 2020-01-07 |
Authorized Official Name | TRICIA ADKISSON (BUSINESS MANAGER) |
Authorized Official Telephone | 9032364050 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
Street Address |
3008 H G MOSLEY PKWY |
City | LONGVIEW |
State | TX |
Zip Code | 75605-2948 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164977997 | Madison Mack | Dentist | 3008 H G Mosley Pkwy, Longview, TX 75605-2948 | 2016-08-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194353730 | Dusty Rae Hane | Nurse Practitioner | Diagnostic Clinic of Longview, 2901 N Fourth St, Longview, TX 75605 | 2020-03-30 |
1831720374 | Kaycee Whatley | Nurse Practitioner | 323 W Hawkins Parkway, Longview, TX 75605 | 2020-02-03 |
1245733492 | Somers Pediatrics | Pediatrics | 103 W. Loop 281, Suite 474, Longview, TX 75605 | 2018-03-14 |
1467838391 | Piney Woods Er II LLC | Clinic/Center | 120 East Loop 281, Longview, TX 75605 | 2015-08-03 |
1386023968 | Elizabeth Ann Heeb Tidwell | Obstetrics & Gynecology | 802 Medical Dr Ste 100, Longview, TX 75605 | 2015-05-28 |
1215353651 | Tracy Hicks | Nurse Practitioner | 102 Commander Dr Ste 9, Longview, TX 75605 | 2014-03-10 |
1073881280 | Deirdre Scotter | Specialist/Technologist | 201 E Tomlinson Pkwy, Longview, TX 75605 | 2011-12-02 |
1316230139 | Traditions Hospice of Longview, LLC | Hospice Care, Community Based | 4362 N Us Hwy 259, Suite B, Longview, TX 75605 | 2011-05-26 |
1184916769 | Telema Dikibujiri Nga | Pediatrics | Longview Regional Medical Center, 2901 North Fourth Street, Longview, TX 75605 | 2011-05-13 |
1902101108 | The Veta Lewis Behavioral Health Group | Counselor | 1800 S. Judson St., Suite 100, Longview, TX 75605 | 2011-01-19 |
Find all providers in zip 75605 |
Taxonomy Code | 261QD0000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Dental |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750825394 | Jd Troy Dds Pllc | Clinic/Center | 1118 Ocean Beach Hwy, Longview, WA 98632-4638 | 2016-12-16 |
1710312764 | Smiles of Tomorrow | Clinic/Center | 4 Huntington Cir, Longview, TX 75601-3537 | 2013-09-10 |
1619590593 | Tsd Kendall & Gengel Pllc | Clinic/Center | 444 Forest Sq Ste E, Longview, TX 75605-4463 | 2020-05-26 |
1043855703 | Longview Family and Emergancy Dental Care Pllc | Clinic/Center | 2840 Bill Owens Pkwy Ste B, Longview, TX 75605-2150 | 2019-11-16 |
1598322463 | Longview Family Dental II | Clinic/Center | 2901 Bill Owens Pkwy, Longview, TX 75605-1601 | 2019-05-25 |
1033628920 | Mack and Hansen Orthodontics, Pllc | Clinic/Center | 1405 Judson Rd, Longview, TX 75601-3918 | 2017-09-24 |
1841641669 | Kopemak Dental Specialists, Pllc | Clinic/Center | 444 Forest Sq, Suite A, Longview, TX 75605-4463 | 2016-06-22 |
1407244221 | Dr. Julia Gourley Dmd PC | Clinic/Center | 2020 9th Ave Ste A, Longview, WA 98632-4072 | 2014-12-31 |
1770806275 | Eid, Jaber, Jassar, Pllc | Clinic/Center | 1717 Olympia Way, Suite 108, Longview, WA 98632-3929 | 2010-03-11 |
1710127378 | Brenda Copeland Dds Pa | Clinic/Center | 723 N 4th St, Longview, TX 75601-5412 | 2009-02-23 |
Find all providers in LONGVIEW |
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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.