Groesbeck Dentist PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

22841 Issued in TX

Legal business name

GROESBECK DENTIST PLLC

Doing business as

Stevens Dental

Practice address

902 W Yeagua St
Groesbeck, TX 76642-3526

Phone

(254) 729-8400

Fax

(254) 729-8407

NPI assigned

Jun 22, 2015

Last updated

Jun 22, 2015By 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. Michael Stevens, DDS

Title

President

Phone

(254) 729-8400

Specialties & licenses 1

Addresses

Other names 1

• Stevens Dental Doing business as

Locations

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434931200000",
    "number": "1326420779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 W YEAGUA ST",
            "city": "GROESBECK",
            "state": "TX",
            "postal_code": "766423526",
            "telephone_number": "254-729-8400",
            "fax_number": "254-729-8407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 W YEAGUA ST",
            "city": "GROESBECK",
            "state": "TX",
            "postal_code": "766423526",
            "telephone_number": "254-729-8400",
            "fax_number": "254-729-8407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROESBECK DENTIST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-22",
        "last_updated": "2015-06-22",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "254-729-8400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "22841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stevens Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Charles Samuel Dillon III, DDS
• Dale E. Dyer, F.N.P.
• Donald Lynn Glass, ATC, LAT
• Eduardo Abraham Gonzalez Fernandez, MD
• Groesbeck City Drug
• Groesbeck Family Dental
• Groesbeck Healthcare Residence LLC (Windsor Nursing and Rehab Center)
• Groesbeck Isd
• Groesbeck LTC Partners, Inc.
• Groesbeck Therapy Services

• Dentist in Groesbeck, TX
• Providers in Groesbeck, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; 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.