Seaside Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SEASIDE DENTAL PLLC

Practice address

1821 S Valley Mills Dr Ste 195
Waco, TX 76711-2119

Phone

(512) 436-8041

NPI assigned

Feb 7, 2014

Organization subpart

No

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

Authorized official

Name

Kyle Raymond, DDS

Title

Owner

Phone

(512) 436-8041

Specialties & licenses 1

Addresses

Other names 1

• Waco Dental Specialists Doing business as

Locations

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

{
    "created_epoch": "1391731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391731200000",
    "number": "1669896932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 S VALLEY MILLS DR STE 195",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767112119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 S VALLEY MILLS DR STE 195",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767112119",
            "telephone_number": "512-436-8041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASIDE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-07",
        "last_updated": "2014-02-07",
        "status": "A",
        "authorized_official_last_name": "RAYMOND",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-436-8041",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waco Dental Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Alexandrea Sebastian
• Seed & Sow PLLC
• Sarah Seelye, FNP
• Lisa Diann Seibert, APRN, CNM, RNC-OB

• Dentist in Waco, TX
• Providers in Waco, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.