Dr. Kelly Wade Mack, DDS
Dr. Kelly Wade Mack is a General Practice Dentistry provider (Dentist) practicing in Longview, TX, registered in the NPPES registry with NPI 1780702472 since 2007. The credential DDS stands for Doctor of Dental Surgery.
✓ Active NPI ✓ Valid NPI checksum Sole proprietor
| NPI | 1780702472 |
|---|---|
| Entity type | Individual (Type 1) |
| Name | Dr. Kelly Wade Mack |
| Credential | DDS |
| Sex | Male |
| Practice address | Longview, TX, 75605 |
| Phone | 9037533673 |
| Fax | 9037532637 |
| Enumeration date | 2007-03-27 |
| Last updated in NPPES | 2007-07-08 |
Street address withheld — NPPES sole-proprietor addresses can be home addresses. See our data policy.
Taxonomy & licenses
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 1223G0001X | General Practice Dentistry | Primary | 12211 | TX |
DDS — Doctor of Dental Surgery: A licensed dentist; DDS and DMD are equivalent dental degrees. About the DDS credential
Copy-ready billing details
Provider: Kelly Mack, DDS NPI: 1780702472 Taxonomy: 1223G0001X (General Practice Dentistry) Address: Longview, TX, 75605
Other providers at this practice address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1497303283 | Baleigh Mack | Individual | General Practice Dentistry | Longview, TX |
Verify this record
Cross-check NPI 1780702472 against the authoritative CMS record: view Dr. Kelly Wade Mack on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
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Is NPI 1780702472 active?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2007-07-08.