FRESH DENTAL & ORTHODONTICS
NPI 1093000804
Dentist in Tyler, TX

Q: What is Fresh Dental PLLC's NPI number?

The NPI number for Fresh Dental PLLC is 1093000804. It was assigned to this organization in the NPPES registry on June 9, 2011. The provider is doing business as Fresh Dental & Orthodontics.

Q: What is Fresh Dental PLLC's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Fresh Dental PLLC was last updated on April 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 09, 2011

3873 HWY 64 W, TYLER, TX 75704(972) 869-3789 Get Directions Write a Review

NPPES record last updated: April 25, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Fresh Dental & Orthodontics NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FRESH DENTAL & ORTHODONTICS (NPI 1093000804) is a healthcare organization registered as a dentist in Tyler, Texas and active in the NPI registry since June 2011. The organization lists Mary Pu, Cfo, as its authorized official.

NPPES Registry Identity

NPI1093000804

Entity TypeOrganization

Primary Taxonomy122300000X

Legal Business NameFRESH DENTAL PLLC

Location Address3873 HWY 64 WTyler, TX 75704-6925

Mailing AddressPo Box 734753Dallas, TX 75373-4753 · (972) 869-3789

Phone(972) 869-3789

Organization SubpartNo

Authorized OfficialMary PuCfo · (972) 869-3789

Enumeration DateJune 9, 2011

Last NPPES UpdateApril 25, 2023

NPPES CertifiedApril 25, 2023

✔ NPI 1093000804 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

3873 HWY 64 W, Tyler, TX 75704

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Other Names 1

Doing Business AsFresh Dental & Orthodontics

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHARMIAH AMIE

Dentist

3873 HWY 64 W
TYLER, TX 75704

Smith County (903) 593-4872

JAY PATEL

Dentist (Orthodontics and Dentofacial Orthopedics)

3873 HWY 64 W
TYLER, TX 75704

Smith County (903) 525-6983

ALAN ANDERSON

Dentist

3873 HWY 64 W
TYLER, TX 75704

Smith County (903) 593-4867

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fresh Dental PLLC's NPI number?

The NPI number for Fresh Dental PLLC is 1093000804. It was assigned to this organization in the NPPES registry on June 9, 2011. The provider is doing business as Fresh Dental & Orthodontics.

Where is Fresh Dental PLLC located?

Fresh Dental PLLC is located at 3873 Hwy 64 W, Tyler, TX 75704. The listed phone number is (972) 869-3789.

What is Fresh Dental PLLC's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

What insurance does Fresh Dental PLLC accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 2 other insurers list Fresh Dental PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Fresh Dental PLLC was last updated on April 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.