South Plains Pediatric Dental Group in Lubbock - Pediatric Dentistry
South Plains Pediatric Dental Group - NPI 1154504918
South Plains Pediatric Dental Group is a Pediatric Dentistry in Lubbock, Texas. South Plains Pediatric Dental Group practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for South Plains Pediatric Dental Group is 1154504918. The last update date is 2007-12-14.
South Plains Pediatric Dental Group's current location address is 5102 Salem Ave, Lubbock, Texas. You can contact this provider via phone number 8067959503. The mailing address for South Plains Pediatric Dental Group is 5102 Salem Ave, Lubbock, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | South Plains Pediatric Dental Group |
|---|---|
| Address | 5102 Salem Ave, Lubbock, Texas |
| Phone Number | 8067959503 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER/PART |
|---|---|
| Authorized Official Name | Kennel Dietmar |
| Credentials | DDS |
| Telephone Number | 8067959503 |
NPI Number Detail
| NPI Number | 1154504918 |
|---|---|
| Provider Enumeration Date | 2007-12-14 |
| Last Updated Date | 2007-12-14 |
Provider Mailing Address Detail
| Address | 5102 Salem Ave |
|---|---|
| City | Lubbock |
| State | Texas (TX) |
| Post Code | 794144036 |
| Phone Number | 8067959503 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 19264 |
|
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
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What is the unique identifier code issued to South Plains Pediatric Dental Group by the Centers for Medicare & Medicaid Services?
The South Plains Pediatric Dental Group has been assigned the NPI (National Provider Identifier) 1154504918. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of South Plains Pediatric Dental Group?
The South Plains Pediatric Dental Group is situated at 5102 Salem Ave, in the city of Lubbock, state of TX, with the zip code 794144036.
What is South Plains Pediatric Dental Group's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for South Plains Pediatric Dental Group is Pediatric Dentistry, and the taxonomy code that classifies this field of practice is 1223P0221X.
When was the South Plains Pediatric Dental Group's 1154504918 issued?
The South Plains Pediatric Dental Group's 1154504918 was issued on 2007-12-14.
As of what date were the details related to South Plains Pediatric Dental Group most recently updated or revised?
The information pertaining to South Plains Pediatric Dental Group, including its address, specialty, and other relevant details, was last updated or revised on 2007-12-14.