DR. KELLY WADE MACK DDS
NPI 1780702472
Dentist - General Practice in Longview, TX

Q: What is Kelly Mack's NPI number?

The NPI number for Kelly Mack is 1780702472. It was assigned to this individual provider in the NPPES registry on March 27, 2007.

Q: What is Kelly Mack's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Mack was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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 March 27, 2007

2200 HORSESHOE LN, LONGVIEW, TX 75605(903) 753-3673(903) 753-2637 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Dr. Kelly Wade Mack Dds NPPES

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

DR. KELLY WADE MACK DDS (NPI 1780702472) is an individual general practice provider in Longview, Texas, licensed in Texas (12211) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1780702472

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. KELLY WADE MACKCredential: DDS

Location Address2200 HORSESHOE LNLongview, TX 75605-5648

Mailing Address2200 Horseshoe LnLongview, TX 75605-5648 · (903) 753-3673 · Fax (903) 753-2637

Phone(903) 753-3673

Fax(903) 753-2637

Sole ProprietorYes

Enumeration DateMarch 27, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1780702472 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in TX · 12211

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

2200 HORSESHOE LN, Longview, TX 75605

Open in Google Maps ↗

Other Providers at the Same Location NPPES

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

DR. BALEIGH PAIGE MACK DDS

Dentist (General Practice)

2200 HORSESHOE LN
LONGVIEW, TX 75605

Gregg County (903) 753-3673

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 Kelly Mack's NPI number?

The NPI number for Kelly Mack is 1780702472. It was assigned to this individual provider in the NPPES registry on March 27, 2007.

Where is Kelly Mack located?

Kelly Mack practices at 2200 Horseshoe Ln, Longview, TX 75605. The listed phone number is (903) 753-3673.

What is Kelly Mack's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Kelly Mack was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.