Provider Demographics
NPI:1790417087
Name:TUMBLEWEED DENTAL, PLLC
Entity Type:Organization
Organization Name:TUMBLEWEED DENTAL, PLLC
Other - Org Name:DON E SANDERS, DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:COVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-358-2472
Mailing Address - Street 1:3625 S SONCY RD
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-6402
Mailing Address - Country:US
Mailing Address - Phone:806-351-2828
Mailing Address - Fax:806-223-4664
Practice Address - Street 1:3625 S SONCY RD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-6402
Practice Address - Country:US
Practice Address - Phone:806-351-2828
Practice Address - Fax:806-223-4664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-27
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1033193842OtherNPPES
TX1407142433OtherNPPES
TX1265572861OtherNPPES
TX1689698714OtherNPPES