Provider Demographics
NPI:1710524426
Name:MAUPIN ENDODONTICS & MICROSURGERY PLLC
Entity Type:Organization
Organization Name:MAUPIN ENDODONTICS & MICROSURGERY PLLC
Other - Org Name:MAUPIN ENDODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:
Authorized Official - Last Name:GASKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-869-3789
Mailing Address - Street 1:6010 82ND ST STE 300
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-0822
Mailing Address - Country:US
Mailing Address - Phone:806-589-3390
Mailing Address - Fax:
Practice Address - Street 1:6010 82ND ST STE 300
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-0822
Practice Address - Country:US
Practice Address - Phone:806-589-3390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-02
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty