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JUPITER DENTAL GROUP PLLC NPI 1033546320


NPI Information

NPI: 1033546320
Provider Name: JUPITER DENTAL GROUP PLLC

Doing Business As: KIDS DENTAL ZONE

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
11000 GARLAND RD
DALLAS, TX
ZIP 75218
Phone: (214) 328-4867
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JUPITER DENTAL GROUP PLLC is a general practice dentist in Dallas, TX. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. JUPITER DENTAL GROUP PLLC NPI is 1033546320. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Kids Dental Zone.

The provider's business location address is:

11000 GARLAND RD
DALLAS, TX
ZIP 75218-615
Phone: (214) 328-4867

The provider's authorized official is Steven Coffman .
The authorized official title is President and has the following contact phone number (702) 300-7886.

The enumeration date for this NPI number is 10/1/2013 and was last updated on 2/26/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice23791TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1205190609MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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