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FULL SMILE DENTAL LAKERIDGE PLLC NPI 1184389355


NPI Information

NPI: 1184389355
Provider Name: FULL SMILE DENTAL LAKERIDGE, PLLC

Former Legal Business Name: FULL SMILE DENTAL LAKERIDGE, PLLC

Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
4425 98TH ST
LUBBOCK, TX
ZIP 79424
Phone: (806) 641-1373
Get Directions

FULL SMILE DENTAL LAKERIDGE, PLLC is an oral and maxillofacial surgery dentist in Lubbock, TX. The provider is 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. FULL SMILE DENTAL LAKERIDGE, PLLC NPI is 1184389355. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Full Smile Dental Lakeridge, Pllc.

The provider's business location address is:

4425 98TH ST
LUBBOCK, TX
ZIP 79424-029
Phone: (806) 641-1373
Fax: (806) 353-7077

The provider's authorized official is Jennifer Lynn Morris .
The authorized official title is Credentialing Specialist and has the following contact phone number (806) 353-1055.

The enumeration date for this NPI number is 11/3/2021 and was last updated on 2/24/2022.


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
11223X0400XDentistOrthodontics and Dentofacial OrthopedicsNo
21223E0200XDentistEndodonticsNo
31223S0112XDentistOral and Maxillofacial SurgeryYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.