Diagnostic Dental Center PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DIAGNOSTIC DENTAL CENTER PLLC

Practice address

1023 N Mound St Ste D
Nacogdoches, TX 75961-4453

Phone

(936) 564-9401

Fax

(936) 564-3907

NPI assigned

Nov 3, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Sidney Jack Fowler, DDSNPI 1982779195

Title

Owner/Dentist

Phone

(936) 564-9401

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Sidney Jack Fowler, DDS

  • General Practice Dentistry
  • Nacogdoches, TX
  • NPI 1982779195
  NPD Authorized official

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

{
    "created_epoch": "1762128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762128000000",
    "number": "1144199639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 N MOUND ST STE D",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614453",
            "telephone_number": "936-564-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 N MOUND ST STE D",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614453",
            "telephone_number": "936-564-9401",
            "fax_number": "936-564-3907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC DENTAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-03",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "SIDNEY",
        "authorized_official_middle_name": "JACK",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "936-564-9401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1659539708",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alex Demotte
• Dennis W Coffman M D
• Dennis W Coffman M.D.
• Dentate PLLC
• Hannah Grubb Deppisch, M.D.
• Dialysis Clinic Inc.
• Steven Charles Dickhaut, M.D.
• Geneva Diosdado
• Lam Nhat DO
• Doctors Surgery Center, Inc

• General Practice Dentistry in Nacogdoches, TX
• Providers in Nacogdoches, 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 Nov 3, 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.