LAKE KIOWA SMILES PLLC NPI 1952889404

NPI Information

  • NPI: 1952889404
  • Provider Name: LAKE KIOWA SMILES, PLLC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Doing Business As: LAKE KIOWA FAMILY DENTAL
  • Address: 100 KIOWA DR W, STE 200
    LAKE KIOWA, TX
    ZIP 76240
  • Phone: (940) 612-1555

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NPI Details

LAKE KIOWA SMILES, PLLC is a general practice dentist in Lake Kiowa, 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. LAKE KIOWA SMILES, PLLC NPI is 1952889404. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Lake Kiowa Family Dental.

The provider's business location address is:

100 KIOWA DR W, STE 200
LAKE KIOWA, TX
ZIP 76240-502
Phone: (940) 612-1555
Fax: (940) 612-1565

The provider's authorized official is Benjamin Tyler Hill .
The authorized official title is Owner and has the following contact phone number (940) 612-1555.

The enumeration date for this NPI number is 8/6/2018 and was last updated on 8/6/2018.

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 Practice25047TEXASYes

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
120547OTHERTEXASSTATE LICENSE

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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