Active NPI
North Mesa Dental, PC
Doing business as Goodland Dentistry
- General Practice Dentistry
- Longview, TX
National Provider Identifier
1245560689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- NORTH MESA DENTAL, PC
- Doing business as
- Goodland Dentistry
- Practice address
- 710 Estes Dr Ste 105
Longview, TX 75602-6120 - Phone
- (770) 916-9000
- Fax
- (678) 247-7858
- NPI assigned
- Jan 7, 2010
- Last updated
- Jun 17, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Dale Mayfield, DMD
- Title
- President
- Phone
- (770) 916-5036
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | NU | ||
| General Practice Dentistry | 1223G0001X | NU | Primary | |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | NU |
Addresses
Primary practice location
710 Estes Dr Ste 105
Longview, TX 75602-6120
Mailing address
1090 Northchase Pkwy SE Ste 150
Marietta, GA 30067-6407
Phone (770) 916-5028
Other names 1
- Goodland Dentistry
National Provider Directory
National Provider Directory- Tax ID family
- Allington Dental
Other organizations with this tax ID 25
Organizations that report the same tax identification number in the National Provider Directory.
Locations
710 Estes Dr
Ste 105
Longview, TX 75602
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262822400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1560729600000",
"number": "1245560689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1090 NORTHCHASE PKWY SE STE 150",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300676407",
"telephone_number": "770-916-5028",
"fax_number": "678-247-7858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 ESTES DR STE 105",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756026120",
"telephone_number": "770-916-9000",
"fax_number": "678-247-7858"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTH MESA DENTAL, PC",
"organizational_subpart": "NO",
"enumeration_date": "2010-01-07",
"last_updated": "2019-06-17",
"status": "A",
"authorized_official_last_name": "MAYFIELD",
"authorized_official_first_name": "DALE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "770-916-5036",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DMD"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Goodland Dentistry",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Longview, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.