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SPECIAL NEEDS DENTISTRY NPI 1023408192


NPI Information

NPI: 1023408192
Provider Name: SPECIAL NEEDS DENTISTRY
Classification: Dentist - 1223D0001X
Entity Type: Organization

Specialization: Dental Public Health

Address:
2420 QUAKER AVE
SUITE 101
LUBBOCK, TX
ZIP 79410
Phone: (806) 701-5066
Get Directions

SPECIAL NEEDS DENTISTRY is a dental public health dentist in Lubbock, TX. The provider is the science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice that serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis. SPECIAL NEEDS DENTISTRY NPI is 1023408192. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2420 QUAKER AVE
SUITE 101
LUBBOCK, TX
ZIP 79410-817
Phone: (806) 701-5066

The provider's authorized official is Russell Wayne Reddell .
The authorized official title is Owner/manager and has the following contact phone number (806) 701-5066.

The enumeration date for this NPI number is 1/28/2015 and was last updated on 1/28/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223D0001XDentistDental Public Health19405TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1180035102MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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