Amarillo Pediatric Dentistry and Orthodontics, PA

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

AMARILLO PEDIATRIC DENTISTRY AND ORTHODONTICS, PA

Practice address

74 Patterson Circle
Boys Ranch, TX 79010

Phone

(806) 350-5437

Fax

(806) 350-5438

NPI assigned

Aug 27, 2018

Last updated

Jul 1, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

AMARILLO PEDIATRIC DENTISTRY AND ORTHODONTICS PAAs reported in NPPES

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

Authorized official

Name

Lynsey Harrison

Title

Coo

Phone

(806) 350-5437

Specialties & licenses 1

Addresses

Tax ID family

Amarillo Pediatric Dentistry and Orthodontics PA2 organizations share this tax ID, including this one

Part of

Amarillo Pediatric Dentistry and Orthodontics PA

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Amarillo Pediatric Dentistry and Orthodontics, PLLC

  dba Amarillo Pediatric Dentistry

  • Pediatric Dentistry
  • Amarillo, TX
  • NPI 1073614772
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Amarillo Pediatric Dentistry and Orthodontics, PLLC

  dba Amarillo Pediatric Dentistry

  • Pediatric Dentistry
  • Amarillo, TX
  • NPI 1073614772
  NPPES parent name

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1063993020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 WOLFLIN AVE",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791091832",
            "telephone_number": "806-350-5437",
            "fax_number": "806-350-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 PATTERSON CIRCLE",
            "city": "BOYS RANCH",
            "state": "TX",
            "postal_code": "79010",
            "telephone_number": "806-350-5437",
            "fax_number": "806-350-5438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMARILLO PEDIATRIC DENTISTRY AND ORTHODONTICS, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMARILLO PEDIATRIC DENTISTRY AND ORTHODONTICS PA",
        "enumeration_date": "2018-08-27",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "LYNSEY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "806-350-5437"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Boys Ranch Isd
• John Hazle Jr., MDIV, MA, LPC-S
• Jonathan Sosa, LMSW

• Pediatric Dentistry in Boys Ranch, TX
• Providers in Boys Ranch, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.