Pediatric Dentistry of Texarkana PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

26442 Issued in TX

Legal business name

PEDIATRIC DENTISTRY OF TEXARKANA PLLC

Practice address

5301 Cowhorn Creek Road
Texarkana, TX 75503

Phone

(901) 833-1141

NPI assigned

Jun 14, 2011

Organization subpart

No

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

Authorized official

Name

Dr. David M Glass, D.D.S.NPI 1053545665

Title

Dentist

Phone

(901) 833-1141

Specialties & licenses 1

Addresses

Other names 1

• Pediatric Dentistry of Texarkana Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Mitchell Glass, D.D.S.

  • Pediatric Dentistry
  • Texarkana, TX
  • NPI 1053545665
  NPD (past) Authorized official

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308009600000",
    "number": "1306131784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 COWHORN CREEK ROAD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "75503",
            "telephone_number": "901-833-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 COWHORN CREEK ROAD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "75503",
            "telephone_number": "901-833-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY OF TEXARKANA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-14",
        "last_updated": "2011-06-14",
        "status": "A",
        "authorized_official_last_name": "GLASS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "901-833-1141",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "26442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Dentistry of Texarkana",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eva Corinne Peacock
• Carol Ann Pearcy, SLP
• Pearson Pediatric OT Services
• Madora Dorie Mason Pearson, OTR
• Michael Reynolds Pearson, DDS
• Elizabeth Penick, LPC, NCC, CCTP
• Heather Pennington, RNFA
• Helen Elizabeth Pennington, RPH
• Carlos Luis Perez, MD
• Permian Premier Health Services Inc

• Pediatric Dentistry in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; 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.