NPIMap

Organization Active NPI

Texarkana Dental Specialists

  • Endodontics
  • Texarkana, TX
National Provider Identifier
1003136714
Registry record updated Jun 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
22320 Issued in TX
Legal business name
TEXARKANA DENTAL SPECIALISTS
Practice address
2800 Texas Blvd
Texarkana, TX 75503-4109
Phone
(903) 792-3636
Fax
(903) 792-0062
NPI assigned
Jun 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Sandra L Shambarger, DDS, MSNPI 1376675769
Title
Vice-President
Phone
(903) 792-3636

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223E0200X 22320 TX Primary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223X0400X 22346 TX

Addresses

Primary practice location

2800 Texas Blvd
Texarkana, TX 75503-4109

Mailing address

2800 Texas Blvd
Texarkana, TX 75503-4109
Phone (903) 792-3636

Other identifiers 1

IdentifierTypeStateIssuer
183406109MedicaidTX

Other names 1

  • Shambarger Orthodontics Doing business as

National Provider Directory

National Provider Directory

Locations

2800 Texas Blvd
Texarkana, TX 75503
Phone (903) 792-3636

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275523200000",
    "number": "1003136714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 TEXAS BLVD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034109",
            "telephone_number": "903-792-3636",
            "fax_number": "903-792-0062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 TEXAS BLVD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034109",
            "telephone_number": "903-792-3636",
            "fax_number": "903-792-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXARKANA DENTAL SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-03",
        "last_updated": "2010-06-03",
        "status": "A",
        "authorized_official_last_name": "SHAMBARGER",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "903-792-3636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "22320",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "22346",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183406109",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shambarger Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Texarkana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.