NPIMap

Organization Active NPI

Meno Group, PLLC

  • General Practice Dentistry
  • Kilgore, TX
National Provider Identifier
1003267212
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MENO GROUP, PLLC
Practice address
1806 Broadway Blvd
Kilgore, TX 75662-3520
Phone
(903) 984-1108
Fax
(903) 984-1107
NPI assigned
Jun 29, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Authorized official

Name
Dr. Angelina Moody-Parker, DDS
Title
Manager
Phone
(903) 984-1108

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1806 Broadway Blvd
Kilgore, TX 75662-3520

Mailing address

1806 Broadway Blvd
Kilgore, TX 75662-3520
Phone (903) 984-1108

Other names 1

  • Kilgore Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

1806 Broadway Blvd
Kilgore, TX 75662
Phone (903) 984-1108

Practitioners & affiliated clinicians

Practitioners 3

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": "1467158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467158400000",
    "number": "1003267212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 BROADWAY BLVD",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756623520",
            "telephone_number": "903-984-1108",
            "fax_number": "903-984-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 BROADWAY BLVD",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756623520",
            "telephone_number": "903-984-1108",
            "fax_number": "903-984-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENO GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-29",
        "last_updated": "2016-06-29",
        "status": "A",
        "authorized_official_last_name": "MOODY-PARKER",
        "authorized_official_first_name": "ANGELINA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "903-984-1108",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kilgore Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kilgore, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; 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.