NPIMap

Organization Active NPI

Lytle Pediatric Dentistry, PLLC

Doing business as Tots to Teens Pediatric Dentistry

  • Pediatric Dentistry
  • Lytle, TX
National Provider Identifier
1649607003
Registry record updated Feb 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
24255 Issued in TX
Legal business name
LYTLE PEDIATRIC DENTISTRY, PLLC
Doing business as
Tots to Teens Pediatric Dentistry
Practice address
19315 McDonald St
Lytle, TX 78052-3622
Phone
(830) 772-5600
NPI assigned
Oct 1, 2013
Last updated
Feb 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2016

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

Authorized official

Name
Joanna AyalaNPI 1730327578
Title
President/Owner
Phone
(210) 632-4560

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 24255 TX Primary

Addresses

Primary practice location

19315 McDonald St
Lytle, TX 78052-3622

Mailing address

PO Box 356
Lytle, TX 78052

Other names 1

  • Tots to Teens Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

19315 McDonald St
Lytle, TX 78052
Phone (830) 772-5600

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": "1380585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454889600000",
    "number": "1649607003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 356",
            "city": "LYTLE",
            "state": "TX",
            "postal_code": "78052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19315 MCDONALD ST",
            "city": "LYTLE",
            "state": "TX",
            "postal_code": "780523622",
            "telephone_number": "830-772-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYTLE PEDIATRIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-01",
        "last_updated": "2016-02-08",
        "status": "A",
        "authorized_official_last_name": "AYALA",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "210-632-4560"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "24255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tots to Teens Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lytle, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; 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.