Panola Dental, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PANOLA DENTAL, PLLC

Practice address

4188 NW Loop
Carthage, TX 75633-2255

Phone

(903) 508-5762

NPI assigned

May 25, 2023

Last updated

May 25, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brent StephensNPI 1417186594

Title

Dentist

Phone

(936) 462-0725

Specialties & licenses 1

Addresses

Locations

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.

• Brent Alan Stephens, DDS

  • General Practice Dentistry
  • Nacogdoches, TX
  • NPI 1417186594
  NPD Authorized official

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684972800000",
    "number": "1285326371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 COUNTY ROAD 509",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759617849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4188 NW LOOP",
            "city": "CARTHAGE",
            "state": "TX",
            "postal_code": "756332255",
            "telephone_number": "903-508-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANOLA DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "936-462-0725",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelcie Lauren Oney, OTR
• Prissi Owens
• Stephanie Ann Page, BSN, RN
• Panola 501 Partners, LP (Panola Nursing & Rehabilitation Center)
• Panola Charter School
• Panola Emergency Medicine Associates PA
• Jim Jason Phillips, MD
• Shannon E Phillips Jr., N.P.
• Premise Health of Texas Medical PA (LP-Carthage)
• Premise Health of Texas Medical, P.a (CareHere A Premise Health company eHealth Center- Carthage)

• Dental Clinic/Center in Carthage, TX
• Providers in Carthage, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.