NPIMap

Organization Active NPI

Mack Dental

  • Dental Clinic/Center
  • Longview, TX
National Provider Identifier
1942840004
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
MACK DENTAL
Practice address
3008 H G Mosley Pkwy
Longview, TX 75605-2948
Phone
(903) 236-4050
Fax
(903) 753-4426
NPI assigned
Jan 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Authorized official

Name
Tricia Adkisson
Title
Business Manager
Phone
(903) 236-4050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

3008 H G Mosley Pkwy
Longview, TX 75605-2948

Mailing address

3008 H G Mosley Pkwy
Longview, TX 75605-2948
Phone (903) 236-4050

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address businessmanager@chrismackdds.com
Direct Messaging Address businessmanager@chrismackdds.com
Direct Messaging Address businessmanager@chrismackdds.com

National Provider Directory

National Provider Directory

Locations

3008 H G Mosley Pkwy
Longview, TX 75605
Phone (903) 236-4050

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578355200000",
    "number": "1942840004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3008 H G MOSLEY PKWY",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052948",
            "telephone_number": "903-236-4050",
            "fax_number": "903-753-4426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3008 H G MOSLEY PKWY",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052948",
            "telephone_number": "903-236-4050",
            "fax_number": "903-753-4426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACK DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-07",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A",
        "authorized_official_last_name": "ADKISSON",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "903-236-4050"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "businessmanager@chrismackdds.com",
            "affiliation": "N",
            "address_1": "3008 H G Mosley Pkwy",
            "city": "Longview",
            "state": "TX",
            "country_code": "US",
            "postal_code": "756052948",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "businessmanager@chrismackdds.com",
            "affiliation": "N",
            "address_1": "3008 H G Mosley Pkwy",
            "city": "Longview",
            "state": "TX",
            "country_code": "US",
            "postal_code": "756052948",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "businessmanager@chrismackdds.com",
            "affiliation": "N",
            "address_1": "3008 H G Mosley Pkwy",
            "city": "Longview",
            "state": "TX",
            "country_code": "US",
            "postal_code": "756052948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; 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.