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SOUTH TYLER FAMILY DENTISTRY PLLC NPI 1548636061


NPI Information

NPI: 1548636061
Provider Name: SOUTH TYLER FAMILY DENTISTRY PLLC

Doing Business As: FRESH DENTAL AND ORTHODONTICS

Classification: Dentist - 122300000X
Entity Type: Organization
Address:
8942 S BROADWAY AVE STE 128
TYLER, TX
ZIP 75703
Phone: (903) 594-4562
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SOUTH TYLER FAMILY DENTISTRY PLLC is a dentist in Tyler, TX. The provider is a dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. SOUTH TYLER FAMILY DENTISTRY PLLC NPI is 1548636061. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Fresh Dental And Orthodontics.

The provider's business location address is:

8942 S BROADWAY AVE STE 128
TYLER, TX
ZIP 75703-443
Phone: (903) 594-4562

The provider's authorized official is Jenny Garcia .
The authorized official title is Credentialing Lead and has the following contact phone number (972) 869-3789.

The enumeration date for this NPI number is 8/19/2015 and was last updated on 11/21/2022.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1122300000XDentistYes

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: 5/5/2024

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