Organization Active NPI

Spearmint Dental Wichita Falls PLLC

  • Dentist
  • Wichita Falls, TX
National Provider Identifier
1770850331
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SPEARMINT DENTAL WICHITA FALLS PLLC
Practice address
3201 Lawrence Rd Ste 375
Wichita Falls, TX 76308-1638
Phone
(940) 691-4867
Fax
(972) 869-3791
NPI assigned
Nov 28, 2011
Last updated
May 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Authorized official

Name
Mary Pu
Title
VP of Finance
Phone
(972) 869-3789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

3201 Lawrence Rd Ste 375
Wichita Falls, TX 76308-1638

Mailing address

PO Box 734753
Dallas, TX 75373-4753
Phone (972) 869-3789

National Provider Directory

National Provider Directory

Locations

3201 Lawrence Rd
Ste 375
Wichita Falls, TX 76308
Phone (940) 432-3404

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": "1322438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651622400000",
    "number": "1770850331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 734753",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753734753",
            "telephone_number": "972-869-3789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 LAWRENCE RD STE 375",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763081638",
            "telephone_number": "940-691-4867",
            "fax_number": "972-869-3791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEARMINT DENTAL WICHITA FALLS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-28",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A",
        "authorized_official_last_name": "PU",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; 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.