Active NPI
Lindon Endsley DDS
- General Practice Dentistry
- Waco, TX
National Provider Identifier
1104480417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- LINDON ENDSLEY DDS
- Practice address
- 2098 N Valley Mills Dr Ste a
Waco, TX 76710-2585 - Phone
- (254) 799-9540
- Fax
- (254) 751-0214
- NPI assigned
- Apr 23, 2019
- Organization subpart
- Yes
- Parent organization
- SE SMILE BY DESIGN
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Angel Marie Maynard
- Title
- Practice Manager
- Phone
- (254) 799-9540
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary |
Addresses
Primary practice location
2098 N Valley Mills Dr Ste a
Waco, TX 76710-2585
Mailing address
2098 N Valley Mills Dr Ste a
Waco, TX 76710-2585
Phone (254) 799-9540
Other names 1
- SE Smile By Design
National Provider Directory
National Provider Directory- Part of
- SE Smile by Design
Locations
2098 N Valley Mills Dr
Ste A
Waco, TX 76710
Phone (254) 776-0691
Ownership & related parties
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.
-
- Dentist
- Waco, TX
- NPI 1194001388
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Waco, TX
- NPI 1225185143
-
- General Practice Dentistry
- Waco, TX
- NPI 1760043541
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555977600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1583798400000",
"number": "1104480417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2098 N VALLEY MILLS DR STE A",
"city": "WACO",
"state": "TX",
"postal_code": "767102585",
"telephone_number": "254-799-9540",
"fax_number": "254-751-0214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2098 N VALLEY MILLS DR STE A",
"city": "WACO",
"state": "TX",
"postal_code": "767102585",
"telephone_number": "254-799-9540",
"fax_number": "254-751-0214"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LINDON ENDSLEY DDS",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SE SMILE BY DESIGN",
"enumeration_date": "2019-04-23",
"last_updated": "2020-03-10",
"certification_date": "2020-03-10",
"status": "A",
"authorized_official_last_name": "MAYNARD",
"authorized_official_first_name": "ANGEL",
"authorized_official_middle_name": "MARIE",
"authorized_official_title_or_position": "PRACTICE MANAGER",
"authorized_official_telephone_number": "254-799-9540",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "SE Smile By Design",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.