Boozer-Lindsey PA

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

BOOZER-LINDSEY PA

Practice address

6300 State Highway 19 S
Athens, TX 75751-8966

Phone

(903) 675-2023

NPI assigned

Jun 3, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Kent Byron Boozer, D.D.S.

Title

Dentist

Phone

(903) 597-2121

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Athens Dental Works Doing business as

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

• Tifani Poskey Shuttlesworth, D.D.S.

  • Dentist
  • Athens, TX
  • NPI 1083809404
  NPD (past)

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286150400000",
    "number": "1134449945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9499",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757119499",
            "telephone_number": "903-675-0023",
            "fax_number": "903-675-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 STATE HIGHWAY 19 S",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757518966",
            "telephone_number": "903-675-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOOZER-LINDSEY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-03",
        "last_updated": "2010-10-04",
        "status": "A",
        "authorized_official_last_name": "BOOZER",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "BYRON",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "903-597-2121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213370401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Athens Dental Works",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lakisha Nashun Bennings, APRN
• Caleb Beraud
• Melinda Berry
• Jessica Boldwill, MD
• Logan Wiggins Boldwill, M.D.
• Boswellia Corp
• Marcus Daniel Braud, CRNA
• William Carey Brice, OD
• Byron William Briggs, D.D.S
• Christopher W Bristow, DO

• All providers in Athens, TX
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2010; 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.