Special Needs Dentistry

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

19405 Issued in TX

Legal business name

SPECIAL NEEDS DENTISTRY

Practice address

2420 Quaker Ave
Suite 101
Lubbock, TX 79410-1817

Phone

(806) 701-5066

NPI assigned

Jan 28, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Russell Wayne Reddell, DDS

Title

Owner/Manager

Phone

(806) 701-5066

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1422403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422403200000",
    "number": "1023408192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16304 COUNTY ROAD 2040",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794234618",
            "telephone_number": "806-368-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 QUAKER AVE",
            "address_2": "SUITE 101",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101817",
            "telephone_number": "806-701-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIAL NEEDS DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-28",
        "last_updated": "2015-01-28",
        "status": "A",
        "authorized_official_last_name": "REDDELL",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "806-701-5066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": "TX",
            "license": "19405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180035102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evans H Spears, PH.D., CRC
• Hailey Nicole Spears
• Kathryn Thomas Spears
• Matthew William Spears, DO
• Tory Ellen Spears, M.ED. LPC
• Specialty RX
• Ella Carole Speck, MD
• Lillie Kristal Speck
• Spectra Sports Medicine & Physical Therapy, LP
• Speech and Myofunctional Therapy of Lubbock, LLC

• Public Health Dentistry in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Public Health Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; 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.