NPIMap

Organization Active NPI

Lowes Boulevard Family Dentistry, PLLC

Doing business as Smile Magic of Killeen

  • Dentist
  • Killeen, TX
National Provider Identifier
1871126284
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
LOWES BOULEVARD FAMILY DENTISTRY, PLLC
Doing business as
Smile Magic of Killeen
Practice address
1200 Lowes Blvd Ste 112
Killeen, TX 76542-5204
Phone
(940) 220-7833
NPI assigned
Feb 14, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Authorized official

Name
Everett Chad Evans, DDSNPI 1407930050
Title
Owner/Dentist
Phone
(940) 312-5626

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X

Addresses

Primary practice location

1200 Lowes Blvd Ste 112
Killeen, TX 76542-5204

Mailing address

5800 N I 35 Ste 205
Denton, TX 76207-1438

Other names 1

  • Smile Magic of Killeen Doing business as

National Provider Directory

National Provider Directory

Locations

1200 Lowes Blvd
Ste 112
Killeen, TX 76542

Practitioners & affiliated clinicians

Practitioners 4

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": "1581638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1871126284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 N I 35 STE 205",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762071438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 LOWES BLVD STE 112",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765425204",
            "telephone_number": "940-220-7833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWES BOULEVARD FAMILY DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-14",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "EVERETT",
        "authorized_official_middle_name": "CHAD",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "940-312-5626",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Magic of Killeen",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Smile Magic of Killeen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Killeen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.