JCL Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JCL DENTAL PLLC

Practice address

300 Olive St
Smithville, TX 78957-1437

Phone

(512) 237-4420

NPI assigned

Jan 6, 2023

Last updated

Jan 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cinthia FernandezNPI 1376256446

Title

Operations Director

Phone

(940) 399-7106

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Cinthia Fernandez

  • Dental Assistant
  • Smithville, TX
  • NPI 1376256446
  NPD Authorized official
• Ted Carney, D.D.S.

  • General Practice Dentistry
  • Smithville, TX
  • NPI 1417978222
  NPD (past)

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672963200000",
    "number": "1659085488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 OLIVE ST",
            "city": "SMITHVILLE",
            "state": "TX",
            "postal_code": "789571437",
            "telephone_number": "512-237-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 OLIVE ST",
            "city": "SMITHVILLE",
            "state": "TX",
            "postal_code": "789571437",
            "telephone_number": "512-237-4420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JCL DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-06",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "CINTHIA",
        "authorized_official_title_or_position": "OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "940-399-7106"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3413981-03",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristi Hall
• Shavon Ann Hall
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• Kacie Hurta
• James-Leach, Inc. (Kenmar Residential Services)
• Branislav Jokic, M.D.
• Carlo Klott, M.D.
• Knott Alone Therapy, PLLC
• Savannah Lee Knott, LCSW
• Laura Louise Leblanc, FNP-C

• General Practice Dentistry in Smithville, TX
• Providers in Smithville, 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 6, 2023; 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.