Active NPI
South Plains Pediatric Dental Group
- Pediatric Dentistry
- Lubbock, TX
National Provider Identifier
1881877645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 17087
- Legal business name
- SOUTH PLAINS PEDIATRIC DENTAL GROUP
- Practice address
- 5102 Salem Ave
Lubbock, TX 79414-4036 - Phone
- (806) 795-9503
- Fax
- (806) 795-2920
- NPI assigned
- Dec 14, 2007
- Last updated
- Dec 14, 2007
- Organization subpart
- Yes
- Parent organization
- SOUTH PLAINS PEDIATRIC DENTAL GROUP
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. John S Johnson, DDS
- Title
- Partner/Owner
- Phone
- (806) 795-9503
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 17087 | TX | Primary |
Addresses
Primary practice location
5102 Salem Ave
Lubbock, TX 79414-4036
Mailing address
5102 Salem Ave
Lubbock, TX 79414-4036
Phone (806) 795-9503
National Provider Directory
National Provider Directory- Tax ID family
- South Plains Pediatric Dental Group
- Part of
- South Plains Pediatric Dental Group
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pediatric Dentistry
- Lubbock, TX
- NPI 1093923211
-
- Pediatric Dentistry
- Lubbock, TX
- NPI 1154504918
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197590400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1197590400000",
"number": "1881877645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5102 SALEM AVE",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794144036",
"telephone_number": "806-795-9503",
"fax_number": "806-795-2920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5102 SALEM AVE",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794144036",
"telephone_number": "806-795-9503",
"fax_number": "806-795-2920"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTH PLAINS PEDIATRIC DENTAL GROUP",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SOUTH PLAINS PEDIATRIC DENTAL GROUP",
"enumeration_date": "2007-12-14",
"last_updated": "2007-12-14",
"status": "A",
"authorized_official_last_name": "JOHNSON",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "PARTNER/OWNER",
"authorized_official_telephone_number": "806-795-9503",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "17087",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
- South Plains Infusion, Inc
- South Plains Pathology Inc
- South Plains Pediatric Cardiology, P.a.
- South Plains Pediatric Dental Group
- South Plains Pediatric Dental Group
- South Plains Pediatric Dental Group (John S Johnson, DDS)
- South Plains Rehabilitation Hospital, LLC (South Plains Rehab Hospital, an affiliate of UMC and Encompass Health)
- South Plains Rural Health Services, Inc
- South Plains Surgery Center LLC
- South Plains Surgical Associates
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.