Organization Active NPI

Longview Family Dental

  • General Practice Dentistry
  • Longview, TX
National Provider Identifier
1376959379
Registry record updated Jul 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LONGVIEW FAMILY DENTAL
Practice address
410 N 3Rd St
Longview, TX 75601-6507
Phone
(903) 753-2633
NPI assigned
Jul 10, 2014
Last updated
Jul 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2014

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

Authorized official

Name
Dr. William Robert Jennings
Title
Owner
Phone
(940) 206-8956

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

410 N 3Rd St
Longview, TX 75601-6507

Mailing address

410 N 3Rd St
Longview, TX 75601-6507
Phone (903) 753-2633

National Provider Directory

National Provider Directory

Locations

410 N 3rd St
Longview, TX 75601
Phone (903) 753-2633

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404950400000",
    "number": "1376959379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N 3RD ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756016507",
            "telephone_number": "903-753-2633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N 3RD ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756016507",
            "telephone_number": "903-753-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGVIEW FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-10",
        "last_updated": "2014-07-10",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "940-206-8956",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; 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.