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Fresh Dental Pllc

Dentist in Tyler, TX · enumerated 2011 · authorized official Mary Pu, Cfo.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1093000804

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Registry record

Entity type Organization (Type 2)
Legal business name Fresh Dental Pllc
Other name <Unavail>
Practice address 3873 Hwy 64 W, Tyler, TX, 75704
Phone (972) 869-3789
Enumeration date Jun 9, 2011
Last updated in NPPES Apr 25, 2023

Taxonomy & classification

122300000X Dentist Dental Providers Primary

Authorized official

Name Mary Pu
Title Cfo
Phone (972) 869-3789

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.

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Frequently asked questions

What is the NPI number for Fresh Dental Pllc?
The NPI for Fresh Dental Pllc is 1093000804, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Fresh Dental Pllc?
NPPES lists Mary Pu (Cfo) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2023-04-25.