Eagle Dental Center of Texarkana PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

EAGLE DENTAL CENTER OF TEXARKANA PLLC

Practice address

4009 Moores LN
Texarkana, TX 75503

Phone

(903) 794-9974

Fax

(903) 793-6067

NPI assigned

Dec 30, 2013

Organization subpart

No

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

Authorized official

Name

Amanda Miot

Title

Clinic Administrator

Phone

(903) 794-9974

Specialties & licenses 1

Addresses

Other names 1

• Eagle Dental Center PLLC Doing business as

Locations

Practitioners 2

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

• William Todd Hegmann, DDS, MS

  • General Practice Dentistry
  • Texarkana, TX
  • NPI 1265630677
  NPD (past)
• Mark Allan Looney, DDS

  • Dentist
  • Texarkana, TX
  • NPI 1447306972
  NPD (past)

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

{
    "created_epoch": "1388361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591228800000",
    "number": "1134540628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 MOORES LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "75503",
            "telephone_number": "903-794-9974",
            "fax_number": "903-793-6067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 MOORES LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "75503",
            "telephone_number": "903-794-9974",
            "fax_number": "903-793-6067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE DENTAL CENTER OF TEXARKANA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-30",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A",
        "authorized_official_last_name": "MIOT",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "903-794-9974"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagle Dental Center PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lori Leigh Duncan, CCC-SLP
• Richard Keneth Dunlap, DOCTOR OF PHARMACY
• Kris Duren
• Brian Frank Hunter Durham
• Thomas Merle Dvorak, O.D.
• Amber L Easley, RD
• East Texas Border Health Clinic
• East Texas Border Health Clinic
• East Texas Border Health Clinic
• East Texas Border Health Clinic

• Dentist in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Dentist in Texas

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

Verify at the official NPI Registry.