PWD Dentistry Management LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

25864 Issued in TX

Legal business name

PWD DENTISTRY MANAGEMENT LLC

Doing business as

Piney Woods Dental

Practice address

2804 Lake Rd Ste 5
Huntsville, TX 77340-5626

Phone

(936) 439-5227

NPI assigned

Jan 14, 2015

Last updated

Jan 14, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

PWD DENTISTRY MANAGEMENT LLCAs reported in NPPES

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

Authorized official

Name

Mrs. Andrea Lynn Vignos, RDA

Title

Office Manager

Phone

(713) 876-4560

Specialties & licenses 1

Addresses

Other names 1

• Piney Woods Dental Doing business as

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

{
    "created_epoch": "1421193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421193600000",
    "number": "1366831372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 LAKE RD STE 5",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773405626",
            "telephone_number": "713-876-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 LAKE RD STE 5",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773405626",
            "telephone_number": "936-439-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PWD DENTISTRY MANAGEMENT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PWD DENTISTRY MANAGEMENT LLC",
        "enumeration_date": "2015-01-14",
        "last_updated": "2015-01-14",
        "status": "A",
        "authorized_official_last_name": "VIGNOS",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "713-876-4560",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RDA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Piney Woods Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Roanne Maree Pueyo, PHARMD
• Pulse Physician Organization PLLC
• Push Medical Services
• Push Medical Services
• Push Medical Services & Laboratory
• Kailey Pyle
• Blanca Celina Quintanilla, APRN-CNP
• R. Karl Mahaffey, MD P.a.
• Amy Eva Rain, APRN, FNP-C
• Rumisa Raoof, MD

• General Practice Dentistry in Huntsville, TX
• Providers in Huntsville, TX by specialty
• General Practice Dentistry in Texas

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