CUSTOM DENTAL OF CARROLLTON, PLLC (NPI# 1366924383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366924383 |
| Entity Type | Organization |
| Organization Name | CUSTOM DENTAL OF CARROLLTON, PLLC |
| Practice Address |
17610 Midway Rd Ste 110 Dallas TX 75287-6741 |
| Practice Telephone | 4052276100 |
| Mailing Telephone | 4052276100 |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2018-09-06 |
| Authorized Official Name | RENE RODGERS (COO) |
| Authorized Official Telephone | 4052276100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
26171 | TX | Ambulatory Health Care Facilities |
| Street Address |
17610 MIDWAY RD STE 110 |
| City | DALLAS |
| State | TX |
| Zip Code | 75287-6741 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417264524 | Elegant Smiles | Dentist | 17610 Midway Rd Ste 110, Dallas, TX 75287-6741 | 2010-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356846307 | Personal Health Assessment | Internal Medicine | 18320 Michael Angelo Drive, Dallas, TX 75287 | 2018-03-29 |
| 1275051807 | Vermelle Minor | Prosthetist | 4341 Horizon Pkwy 132, Dallas, TX 75287 | 2017-09-04 |
| 1831629625 | Tumikee Perry | Counselor | 2903 Renaissance Circle, Dallas, TX 75287 | 2017-06-14 |
| 1326594177 | Sweta Sheth Dds | Dentist | 18217 Midway Road #122, Dallas, TX 75287 | 2016-08-31 |
| 1003288259 | Hamid Reza Pirnajmedin | Specialist/Technologist, Other | 4808 Haverwood Ln Apt 1236, Dallas, TX 75287 | 2015-10-28 |
| 1013307313 | Kaelee Rae Kail | Occupational Therapist | 17480 Dallas Pkwy # 400, Dallas, TX 75287 | 2015-01-26 |
| 1568875318 | Nicole Carvacho | Physical Therapist | 17480 North Dallas Tollway, Addison, TX 75287 | 2014-06-10 |
| 1326451873 | Holly Davis | Speech-Language Pathologist | 17480 North Dallas Parkway, Suite 221, Dallas, TX 75287 | 2014-06-03 |
| 1033520077 | Tammy Duran | Non-emergency Medical Transport (VAN) | 3653 Briargrove Lane, 1513, Dallas, TX 75287 | 2014-05-13 |
| 1518393206 | Cole Wellness Center | Home Health | 4820 Sea Pine, Dallas, TX 75287 | 2013-09-25 |
| Find all providers in zip 75287 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184230302 | Mi Dentista | Clinic/Center | 3101 W Davis St, Dallas, TX 75211-2921 | 2020-09-22 |
| 1639780083 | Dental Snoring and Apnea Clinic LLC | Clinic/Center | 5477 Glen Lakes Dr Ste 130, Dallas, TX 75231-0967 | 2020-08-10 |
| 1992323257 | Duncanville Dental Pllc | Clinic/Center | 5409 N Jim Miller Rd Ste 105, Dallas, TX 75227-1500 | 2020-07-13 |
| 1427677541 | Mh Dental Group, LLC | Clinic/Center | 1305 Cedarcrest Rd Ste 115, Dallas, GA 30132-8201 | 2020-04-09 |
| 1255961843 | Albatross 46 LLC | Clinic/Center | 4231 Sigma Rd Ste 100, Dallas, TX 75244-4471 | 2020-01-22 |
| 1376187765 | Eckert Dental Pllc | Clinic/Center | 2509 S Hampton Rd Ste 100, Dallas, TX 75224-1623 | 2019-10-30 |
| 1295376788 | Michael J Neeley Dds Inc | Clinic/Center | 9301 N Central Expy Ste 585, Dallas, TX 75231-0811 | 2019-10-05 |
| 1730730813 | Clock Cycle Dental | Clinic/Center | 8550 Plano Rd Ste 104, Dallas, TX 75238-4824 | 2019-09-20 |
| 1396301131 | Atrium Modern Dental | Clinic/Center | 9401 Lyndon B Johnson Fwy Ste 200, Dallas, TX 75243-4548 | 2019-05-17 |
| 1558835553 | Lu Dental Incorporated | Clinic/Center | 6550 Shady Brook Ln Apt 822, Dallas, TX 75206-1212 | 2019-01-14 |
| Find all providers in DALLAS | ||||
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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.