Organization Active NPI

David B. Gregory, D.D.S.,P.a.

  • Dental Clinic/Center
  • Lubbock, TX
National Provider Identifier
1336759208
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DAVID B. GREGORY, D.D.S.,P.A.
Practice address
3302 64TH St
Lubbock, TX 79413-5743
Phone
(806) 792-4889
Fax
(806) 793-2624
NPI assigned
Aug 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Authorized official

Name
Kim Wideman
Title
Office Manager
Phone
(806) 792-4889

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

3302 64TH St
Lubbock, TX 79413-5743

Mailing address

3302 64TH St
Lubbock, TX 79413-5743
Phone (806) 792-4889

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1596585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596585600000",
    "number": "1336759208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3302 64TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794135743",
            "telephone_number": "806-792-4889",
            "fax_number": "806-793-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 64TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794135743",
            "telephone_number": "806-792-4889",
            "fax_number": "806-793-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID B. GREGORY, D.D.S.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-05",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A",
        "authorized_official_last_name": "WIDEMAN",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "806-792-4889"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; 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.