# GRAPEVINE KIDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Grapevine Kids Dental and Orthodontics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295397610
- **Authorized official:** DR. LYLE MATTHEW SCHOFIELD DDS (MANAGING MEMBER)
- **Authorized official phone:** (469) 900-5371

## Contact information

- **Practice address:** 1230 S MAIN ST, GRAPEVINE, TX 76051-5544
- **Practice address phone:** (972) 258-0758
- **Mailing address:** 1230 S MAIN ST, GRAPEVINE, TX 76051-5544
- **Mailing address phone:** (817) 909-2920

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |
| 1223G0001X | General Practice Dentistry | — | — | — |
| 1223P0221X | Pediatric Dentistry | — | — | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | — | — |

## Other

- **Enumeration date:** 07/05/2019
- **Last updated:** 03/06/2024