DIAGNOSTIC DENTAL CENTER PLLC NPI 1144199639

NPI Information

  • NPI: 1144199639
  • Provider Name: DIAGNOSTIC DENTAL CENTER PLLC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 1023 N MOUND ST STE D
    NACOGDOCHES, TX
    ZIP 75961
  • Phone: (936) 564-9401

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NPI Details

DIAGNOSTIC DENTAL CENTER PLLC is a general practice dentist in Nacogdoches, TX. The provider is 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. DIAGNOSTIC DENTAL CENTER PLLC NPI is 1144199639. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1023 N MOUND ST STE D
NACOGDOCHES, TX
ZIP 75961-453
Phone: (936) 564-9401
Fax: (936) 564-3907

The provider's authorized official is Sidney Jack Fowler .
The authorized official title is Owner/dentist and has the following contact phone number (936) 564-9401.

The enumeration date for this NPI number is 11/3/2025 and was last updated on 11/3/2025.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11659539708OTHERTEXASNPI

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: 11/21/2025

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