J LEE PETTIGREW DDS PA NPI 1619364114

NPI Information

  • NPI: 1619364114
  • Provider Name: J LEE PETTIGREW DDS PA
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 201 PLAYERS CIR
    STE 100
    SOUTHLAKE, TX
    ZIP 76092
  • Phone: (817) 481-4888

Map and Directions

Get Directions

NPI Details

J LEE PETTIGREW DDS PA is a dental clinic center in Southlake, TX. J LEE PETTIGREW DDS PA NPI is 1619364114. The provider is registered as an organization entity type.

The provider's business location address is:

201 PLAYERS CIR
STE 100
SOUTHLAKE, TX
ZIP 76092-944
Phone: (817) 481-4888
Fax: (817) 421-7370

The provider's authorized official is Jerry Lee Pettigrew .
The authorized official title is Owner and has the following contact phone number (817) 481-4888.

The enumeration date for this NPI number is 4/22/2015 and was last updated on 4/22/2015.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QD0000XClinic/CenterDental15943TEXASYes

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

NPI Synchronization or Removal

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.