DALLAS ENDODONTICS, P.A. (NPI# 1902954472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1902954472 |
Entity Type | Organization |
Organization Name | DALLAS ENDODONTICS, P.A. |
Practice Address |
11910 Greenville Ave Suite 450 Dallas TX 75243-3596 |
Practice Telephone | 9726441162 |
Practice Fax Number | 9727836660 |
Mailing Telephone | 9726441162 |
Mailing Fax Number | 9727836660 |
Enumeration Date | 2007-01-08 |
Last Update Date | 2016-01-25 |
Authorized Official Name | LORI WILLIS (ADMINISTRATIVE ASST.) |
Authorized Official Telephone | 9726441162 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 1223E0200X |
Dentist Specialization: Endodontics |
10924 | TX | Dental Providers |
N | 1223E0200X |
Dentist Specialization: Endodontics |
16886 | TX | Dental Providers |
Y | 1223E0200X |
Dentist Specialization: Endodontics |
19484 | TX | Dental Providers |
Street Address |
11910 GREENVILLE AVE SUITE 450 |
City | DALLAS |
State | TX |
Zip Code | 75243-3596 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427053040 | Hedley Rakusin | Dentist | 11910 Greenville Ave, Ste 110, Dallas, TX 75243-3564 | 2005-06-20 |
1629523642 | Ashley Smith | Dentist | 11910 Greenville Ave, Suite 110, Dallas, TX 75243-3596 | 2016-08-19 |
1659612752 | Shana Fakkel | Physician Assistant | 11910 Greenville Ave, Suite 500, Dallas, TX 75243-3596 | 2013-03-14 |
1306180096 | Benjamin Scott Scarbro | Nurse Anesthetist, Certified Registered | 11910 Greenville Ave, Suite 650, Dallas, TX 75243-3596 | 2012-11-19 |
1477808897 | Katherine M. Floyd | Nurse Anesthetist, Certified Registered | 11910 Greenville Ave, Suite 650, Dallas, TX 75243-3596 | 2012-07-23 |
1528329307 | Smith Family Dentistry Pa | Dentist | 11910 Greenville Ave, Suite 110, Dallas, TX 75243-3596 | 2012-06-07 |
1770872657 | Florence Nwagwu | Anesthesiology | 11910 Greenville Ave, Suite 650, Dallas, TX 75243-3596 | 2011-03-31 |
1003121112 | Ambreen Feroz Ali Nadeem | Physician Assistant | 11910 Greenville Ave, 500, Dallas, TX 75243-3596 | 2010-08-12 |
1285967174 | Kathryn Branch | Nurse Practitioner | 11910 Greenville Ave, Suite 500, Dallas, TX 75243-3596 | 2009-09-10 |
1235307307 | Charles Gravely | Physician Assistant | 11910 Greenville Ave, Suite 500, Dallas, TX 75243-3596 | 2008-02-12 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558970830 | Nnamdi Okorie | Licensed Vocational Nurse | [email protected], 13427 Hedgeapple Dr, Dallas, TX 75243 | 2020-07-23 |
1629627716 | Mohammad Mehdi Imani Emadi | Dentist | 11970 N Central Expy # 430, Dallas, TX 75243 | 2019-09-10 |
1295221786 | Cornerstonemd,pllc | Obstetrics & Gynecology | 12222 N Central Expy Ste 140, Dallas, TX 75243 | 2018-07-08 |
1033609292 | Mother Earth Healthcare Services Inc | Home Health | 9821 Summerwood Cir Apt 1701, Dallas, TX 75243 | 2018-05-14 |
1346742822 | Chioma Ifeji | Licensed Vocational Nurse | 13317 Daystrom Court, Dallas, TX 75243 | 2018-03-01 |
1598282865 | Kimberly Ann Whitney | Social Worker | 11520 N Central Expy Ste 254, Dallas, TX 75243 | 2017-08-27 |
1962934083 | Dignity Private Care, LLC | In Home Supportive Care | 8330 Lbj Freeway, Ste 720, Dallas, TX 75243 | 2017-03-29 |
1699214569 | Vitalis Home Health LLC | Home Health | 9821 Summerwood Cir Apt 1308, Dallas, TX 75243 | 2017-02-13 |
1881130946 | Proniles | Non-emergency Medical Transport (VAN) | 12611 Hornbeam Dr, Dallas, TX 75243 | 2017-01-13 |
1194273664 | Osman W Awdallah | Non-emergency Medical Transport (VAN) | 12611 Hornbeam Drive, Dallas, TX 75243 | 2016-09-14 |
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Taxonomy Code | 1223E0200X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Endodontics |
The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699323618 | Jaymin Jayantibhai Patel | Dentist | 2112 Boll St Apt 122, Dallas, TX 75204-2835 | 2019-09-03 |
1528520863 | Laura G Taiman Dds Pllc | Dentist | 17000 Preston Rd Ste 480, Dallas, TX 75248-1224 | 2019-04-04 |
1265984470 | Karishma Patil | Dentist | 5925 Forest Ln Ste 314, Dallas, TX 75230-2775 | 2016-11-04 |
1700203411 | Quality Centered Endodontics Pllc | Dentist | 4514 Cole Ave Ste 930, Dallas, TX 75205-4183 | 2014-03-20 |
1982916482 | Robert F Gatti | Dentist | 4627 Travis St, #608, Dallas, TX 75205-4066 | 2010-07-13 |
1487899530 | Root Canal Dentists, Pllc | Dentist | 2924 W Nw Hwy, Dallas, TX 75220-6218 | 2008-12-03 |
1326291295 | Karl F Woodmansey | Dentist | 1215 Waterside Cir, Dallas, TX 75218 | 2008-10-23 |
1053574145 | Jianing He | Dentist | 7001 Preston Rd Ste 301a, Dallas, TX 75205-5104 | 2008-07-08 |
1659560373 | Charles Daniel Bishop | Dentist | 8201 Preston Rd Ste 375, Dallas, TX 75225-6221 | 2007-10-18 |
1316068935 | Rita F. Ne | Dentist | 7001 Preston Rd, Suite 301-a, Dallas, TX 75205-1190 | 2007-04-02 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.