EAGLE MOUNTAIN PEDIATRIC DENTISTRY
NPI 1669080487
Dentist - Pediatric Dentistry in Saginaw, TX

Q: What is Eagle Mountain Pediatric Dentistry's NPI number?

The NPI number for Eagle Mountain Pediatric Dentistry is 1669080487. It was assigned to this organization in the NPPES registry on July 17, 2020.

Q: What is Eagle Mountain Pediatric Dentistry's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Active since July 17, 2020

705 W BAILEY BOSWELL RD, SAGINAW, TX 76179(817) 576-1600 Get Directions Write a Review

NPPES record last updated: July 17, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Eagle Mountain Pediatric Dentistry NPPES

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

EAGLE MOUNTAIN PEDIATRIC DENTISTRY (NPI 1669080487) is a healthcare organization registered as a pediatric dentistry in Saginaw, Texas and active in the NPI registry since July 2020. The organization lists Jeremy Lustig, Ceo, as its authorized official.

NPPES Registry Identity

NPI1669080487

Entity TypeOrganization

Primary Taxonomy1223P0221X

Legal Business NameEAGLE MOUNTAIN PEDIATRIC DENTISTRY

Location Address705 W BAILEY BOSWELL RDSaginaw, TX 76179-1020

Mailing Address3575 Lone Star Cir Ste 310Fort Worth, TX 76177-8908 · (817) 350-6500

Phone(817) 576-1600

Organization SubpartNo

Authorized OfficialJeremy LustigCeo · (214) 335-0862

Enumeration DateJuly 17, 2020

NPPES CertifiedJuly 17, 2020

✔ NPI 1669080487 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers

Taxonomy Code1223P0221X

Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

705 W BAILEY BOSWELL RD, Saginaw, TX 76179

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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

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.

GRILL REPAIR, P.A.

Dentist (Orthodontics and Dentofacial Orthopedics)

705 W BAILEY BOSWELL RD
SAGINAW, TX 76179

Tarrant County (817) 897-6006

DR. JANENE SPERANDEO D.M.D.

Dentist

705 W BAILEY BOSWELL RD
SAGINAW, TX 76179

Tarrant County (817) 232-5997

CHIROPRACTIC & REHAB CENTERS, INC

Chiropractor

705 W BAILEY BOSWELL RD
SAGINAW, TX 76179

Tarrant County (817) 306-8585

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 Eagle Mountain Pediatric Dentistry's NPI number?

The NPI number for Eagle Mountain Pediatric Dentistry is 1669080487. It was assigned to this organization in the NPPES registry on July 17, 2020.

Where is Eagle Mountain Pediatric Dentistry located?

Eagle Mountain Pediatric Dentistry is located at 705 W Bailey Boswell Rd, Saginaw, TX 76179. The listed phone number is (817) 576-1600.

What is Eagle Mountain Pediatric Dentistry's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Eagle Mountain Pediatric Dentistry was last updated on July 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.