Red Dirt Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

RED DIRT DENTAL PLLC

Practice address

104 Water Oaks Blvd Ste B
Lindale, TX 75771-2661

Phone

(903) 977-0290

NPI assigned

Jun 8, 2026

Organization subpart

No

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

Authorized official

Name

Dr. Trevor Justin Wortley, D.M.D.NPI 1538720016

Title

Owner/Dentist

Phone

(801) 889-8321

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.

• Trevor Justin Wortley, DMD

  • General Practice Dentistry
  • Whitehouse, TX
  • NPI 1538720016
  NPD Authorized official

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

{
    "created_epoch": "1780876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780876800000",
    "number": "1326971367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WATER OAKS BLVD STE B",
            "city": "LINDALE",
            "state": "TX",
            "postal_code": "757712661",
            "telephone_number": "903-977-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 WATER OAKS BLVD STE B",
            "city": "LINDALE",
            "state": "TX",
            "postal_code": "757712661",
            "telephone_number": "903-977-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED DIRT DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-08",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A",
        "authorized_official_last_name": "WORTLEY",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_middle_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "801-889-8321",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Professional Clinical Laboratory Inc (ProLab)
• Lori Nicole Puckett, RPH
• Sunny Qin, BS, CNIM
• Shruthi Ravikumar
• Jack Reaume
• Catherine Reed
• Chamecca R Reeves
• Ellen Jean Remenchik, MD
• Jack Wallace Rice, DO
• Julie Michelle Riggs

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; 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.