Affordable Dentures & Implants - Texas, PLLC
Dentist, General Practice in Kyle, TX. Organization (NPI-2).
NPI number1104135797
StatusActive
Last updated in NPPESNov 17, 2021
Details
- NPI
- 1104135797
- Entity type
- Organization (NPI-2)
- Legal business name
- Affordable Dentures & Implants - Texas, PLLC
- Organization subpart
- No
- Enumeration date
- Sep 29, 2010
- Certification date
- Nov 17, 2021
- Last updated
- Nov 17, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
| 122300000X | Dentist | 0021124 | TX |
Practice location
5695 Kyle Pkwy250
Kyle, TX 78640-6305
Phone 918-473-0285 · Fax 918-473-0346
Mailing address
5695 Kyle Pkwy250
Kyle, TX 78640-6305
Authorized official
Haley Wooster
Enrollment Specialist
7127338551
Is something wrong?
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All 26 General Practice Dentistry providers in Kyle · All 1,070 providers in Kyle
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