NPIMap

Organization Active NPI

Pinecrest Developmental Center

Doing business as Pinecrest Dental Clinic

  • Dental Clinic/Center
  • Pineville, LA
National Provider Identifier
1174852875
Registry record updated Dec 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
PINECREST DEVELOPMENTAL CENTER
Doing business as
Pinecrest Dental Clinic
Practice address
100 Pinecrest Dr
Attn: Paxton Oliver
Pineville, LA 71360-4276
Phone
(318) 487-5395
Fax
(318) 487-5463
NPI assigned
Dec 9, 2009
Organization subpart
Yes
Parent organization
PINECREST DEVELOPMENTAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 9, 2009

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

Authorized official

Name
Mr. Paxton E. Oliver II, M.S.NPI 1952634222
Title
Mr/DD Regional Assoc. Administrator
Phone
(318) 487-5395

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X LA Primary

Addresses

Primary practice location

100 Pinecrest Dr
Attn: Paxton Oliver
Pineville, LA 71360-4276

Mailing address

PO Box 5191
Attn; Paxton Oliver
Pineville, LA 71361-5191
Phone (318) 487-5395

Other names 1

  • Pinecrest Dental Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pinecrest Supports and Services Center19 organizations share this tax ID, including this one
Part of
Pinecrest Supports and Services Center

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1260316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260316800000",
    "number": "1174852875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5191",
            "address_2": "ATTN; PAXTON OLIVER",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713615191",
            "telephone_number": "318-487-5395",
            "fax_number": "318-487-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PINECREST DR",
            "address_2": "ATTN: PAXTON OLIVER",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713604276",
            "telephone_number": "318-487-5395",
            "fax_number": "318-487-5463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINECREST DEVELOPMENTAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PINECREST DEVELOPMENTAL CENTER",
        "enumeration_date": "2009-12-09",
        "last_updated": "2009-12-09",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "PAXTON",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "MR/DD REGIONAL ASSOC. ADMINISTRATOR",
        "authorized_official_telephone_number": "318-487-5395",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pinecrest Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pineville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; 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.