Scott Distefano DDS PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SCOTT DISTEFANO DDS PLLC

Practice address

3535 N Fourth St Ste 303
Longview, TX 75605-0038

Phone

(903) 759-4607

NPI assigned

Aug 13, 2025

Organization subpart

No

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

Authorized official

Name

Jenny Garcia-Rocha

Title

Sr Credentialing Team Lead

Phone

(972) 869-3789

Specialties & licenses 1

Addresses

Other names 1

• DiStefano Dental Studio Doing business as

Locations

Practitioners 1

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

• Scott Edward Distefano, DDS

  • General Practice Dentistry
  • Longview, TX
  • NPI 1861593014
  NPD

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

{
    "created_epoch": "1755043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755043200000",
    "number": "1114803483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 N FOURTH ST STE 303",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756050038",
            "telephone_number": "903-759-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 N FOURTH ST STE 303",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756050038",
            "telephone_number": "903-759-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT DISTEFANO DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-13",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A",
        "authorized_official_last_name": "GARCIA-ROCHA",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "SR CREDENTIALING TEAM LEAD",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "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": "DiStefano Dental Studio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy Schultz, A.U.
• James Michael Schumacher, RPH
• Anna D Schwoyer, APRN
• Scissor Tail Enterprises LLC Dba Scissortail Medical Supply
• Alexis Scoggin, SLP
• Anna Scott
• Marla Scott, LPC
• Michael Woodward Scott, D.D.S., M.S.D.
• Ronald Allen Scott, M.D.
• Stephanie N Scott

• General Practice Dentistry in Longview, TX
• Providers in Longview, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; 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.