Provider Demographics
NPI:1457877995
Name:WILLIAM B. LANGSTON III, DDS PC
Entity Type:Organization
Organization Name:WILLIAM B. LANGSTON III, DDS PC
Other - Org Name:WILLIAM B. LANGSTON III, DDS PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-270-6533
Mailing Address - Street 1:3635 N BELT LINE RD STE 160
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-9235
Mailing Address - Country:US
Mailing Address - Phone:972-270-6533
Mailing Address - Fax:972-270-6578
Practice Address - Street 1:3635 N BELT LINE RD STE 160
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-9235
Practice Address - Country:US
Practice Address - Phone:972-270-6533
Practice Address - Fax:972-270-6533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-16
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1801917646Medicaid