Provider Demographics
NPI:1225873847
Name:LITTLE SPROUTS PEDIATRIC DENTISTRY PLLC
Entity type:Organization
Organization Name:LITTLE SPROUTS PEDIATRIC DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCNAIR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:228-219-9601
Mailing Address - Street 1:15141 RONALD W REAGAN BLVD STE 517&519
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-1241
Mailing Address - Country:US
Mailing Address - Phone:737-777-6230
Mailing Address - Fax:737-777-6229
Practice Address - Street 1:15141 RONALD W REAGAN BLVD STE 517&519
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-1241
Practice Address - Country:US
Practice Address - Phone:737-777-6230
Practice Address - Fax:737-777-6229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty