NPIMap

Organization Active NPI

Abbeville Dentistry - Lubbock Pueblo, PLLC

  • General Practice Dentistry
  • Lubbock, TX
National Provider Identifier
1356092324
Registry record updated Aug 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ABBEVILLE DENTISTRY - LUBBOCK PUEBLO, PLLC
Practice address
5102 Salem Ave
Lubbock, TX 79414-4036
Phone
(502) 254-8500
NPI assigned
Jan 12, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2022

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

Authorized official

Name
Jeff Reibel
Title
Cfo
Phone
(502) 254-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

5102 Salem Ave
Lubbock, TX 79414-4036

Mailing address

PO Box 437169
Louisville, KY 40253-7169
Phone (502) 254-8500

Other names 1

  • Lubbock Salem Ave Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Abbeville Dentistry - Lubbock Pueblo PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660694400000",
    "number": "1356092324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 437169",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402537169",
            "telephone_number": "502-254-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5102 SALEM AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794144036",
            "telephone_number": "502-254-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABBEVILLE DENTISTRY - LUBBOCK PUEBLO, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-12",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A",
        "authorized_official_last_name": "REIBEL",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-254-8500"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lubbock Salem Ave",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 17, 2022; 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.