Pinnacle Implants and Periodontics

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

PINNACLE IMPLANTS AND PERIODONTICS

Practice address

444 Forest SQ Ste a
Longview, TX 75605-4463

Phone

(903) 758-3329

NPI assigned

Mar 2, 2026

Organization subpart

No

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

Authorized official

Name

Jennifer Heritage

Title

Credentialing Manager

Phone

(402) 805-4516

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1772409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773014400000",
    "number": "1417802810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 FOREST SQ STE A",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756054463",
            "telephone_number": "903-758-3329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 FOREST SQ STE A",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756054463",
            "telephone_number": "903-758-3329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4210 McKnight Rd",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "TX",
            "postal_code": "755030922",
            "country_code": "US",
            "telephone_number": "903-838-0511",
            "fax_number": "903-838-0523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PINNACLE IMPLANTS AND PERIODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-02",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A",
        "authorized_official_last_name": "HERITAGE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "402-805-4516"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Longview, TX
• Providers in Longview, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.