NPIMap

Organization Active NPI

Abbeville Dentistry - Lubbock Pueblo, PLLC

Doing business as Lubbock Dentistry for Kids

  • Pediatric Dentistry
  • Lubbock, TX
National Provider Identifier
1790296226
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
ABBEVILLE DENTISTRY - LUBBOCK PUEBLO, PLLC
Doing business as
Lubbock Dentistry for Kids
Practice address
4217 85TH St
Lubbock, TX 79423-1931
Phone
(502) 254-8500
NPI assigned
Oct 24, 2017
Last updated
Sep 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Authorized official

Name
Jeff Reibel
Title
Cfo
Phone
(502) 254-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X Primary

Addresses

Primary practice location

4217 85TH St
Lubbock, TX 79423-1931

Mailing address

PO Box 437169
Louisville, KY 40253-7169

Other names 1

  • Lubbock Dentistry for Kids Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Abbeville Dentistry - Lubbock Pueblo PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4217 85th St
Lubbock, TX 79423
Phone (806) 687-8080

NPI Registry JSON

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

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693872000000",
    "number": "1790296226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 437169",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402537169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4217 85TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794231931",
            "telephone_number": "502-254-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABBEVILLE DENTISTRY - LUBBOCK PUEBLO, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-24",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A",
        "authorized_official_last_name": "REIBEL",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-254-8500"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lubbock Dentistry for Kids",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.