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J LEE PETTIGREW DDS PA
NPI 1619364114
Clinic/Center - Dental in Southlake, TX

Active since April 22, 2015
201 PLAYERS CIR, STE 100, SOUTHLAKE, TX 76092(817) 481-4888(817) 421-7370 Get Directions Write a Review

NPPES record last updated: April 22, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About J Lee Pettigrew Dds Pa NPPES

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

J LEE PETTIGREW DDS PA (NPI 1619364114) is a healthcare organization registered as a dental in Southlake, Texas and active in the NPI registry since April 2015. The organization lists Jerry Lee Pettigrew, Owner, as its authorized official.

NPPES Registry Identity

NPI1619364114
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameJ LEE PETTIGREW DDS PA
Location Address201 PLAYERS CIR, STE 100Southlake, TX 76092-6944
Mailing Address201 Players Cir, Ste 100Southlake, TX 76092-6944 · (817) 481-4888 · Fax (817) 421-7370
Phone(817) 481-4888
Fax(817) 421-7370
Organization SubpartNo
Authorized OfficialJerry Lee PettigrewOwner · (817) 481-4888
Enumeration DateApril 22, 2015
✔ NPI 1619364114 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
License✔ Licensed in TX · 15943
201 PLAYERS CIR, Southlake, TX 76092
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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 J Lee Pettigrew Dds PA's NPI number?

The NPI number for J Lee Pettigrew Dds PA is 1619364114. It was assigned to this organization in the NPPES registry on April 22, 2015.

Where is J Lee Pettigrew Dds PA located?

J Lee Pettigrew Dds PA is located at 201 Players Cir Ste 100, Southlake, TX 76092. The listed phone number is (817) 481-4888.

What is J Lee Pettigrew Dds PA's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for J Lee Pettigrew Dds PA was last updated on April 22, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.