Seagoville Mirror Lake Dentistry PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SEAGOVILLE MIRROR LAKE DENTISTRY PLLC

Practice address

605 Avalon Dr
Seagoville, TX 75159-3034

Phone

(972) 287-5311

NPI assigned

Sep 6, 2019

Organization subpart

No

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

Authorized official

Name

Angel Parker

Title

Leadership

Phone

(972) 200-1190

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567728000000",
    "number": "1295384873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 AVALON DR",
            "city": "SEAGOVILLE",
            "state": "TX",
            "postal_code": "751593034",
            "telephone_number": "972-287-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 AVALON DR",
            "city": "SEAGOVILLE",
            "state": "TX",
            "postal_code": "751593034",
            "telephone_number": "972-287-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEAGOVILLE MIRROR LAKE DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-06",
        "last_updated": "2019-09-06",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_title_or_position": "LEADERSHIP",
        "authorized_official_telephone_number": "972-200-1190"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "admin@mirrorlakedentistry.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "605 Avalon Dr",
            "city": "Seagoville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "751593034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Seagoville Dental Group PLLC
• Seagoville Womens Clinic, LLC
• Darla Ann Shlensky, R.PH.
• Trenda L Snell, RCPHT
• Angelica Soto, FNP
• T&T Homecare Partners LLC

• Dental Clinic/Center in Seagoville, TX
• Providers in Seagoville, 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 Sep 6, 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.

Verify at the official NPI Registry.