Jackson Matthew Lloyd, DDS
Individual provider Active NPI Dentist · Van Alstyne, TX
NPI 1194536870 · NPPES record last updated Jan 14, 2025
Key facts
- NPI
- 1194536870
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 41167 (TX)
- Practice address
- 1286 W Van Alstyne Pkwy
Van Alstyne, TX 75495-4390 - Phone
- (903) 712-4440
- NPI assigned
- Jan 14, 2025
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Van Alstyne Dental PLLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 41167 | TX | Yes |
Addresses
Primary practice location
1286 W Van Alstyne Pkwy
Van Alstyne, TX 75495-4390
Mailing address
1050 Packsaddle TRL
Prosper, TX 75078-9476
Phone (972) 838-3502
Other providers in Van Alstyne, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.