CLEBURNE DENTAL STUDIO PLLC NPI 1952824468

NPI Information

  • NPI: 1952824468
  • Provider Name: CLEBURNE DENTAL STUDIO PLLC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 1607 W HENDERSON ST STE K
    CLEBURNE, TX
    ZIP 76033
  • Phone: (817) 522-3166

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NPI Details

CLEBURNE DENTAL STUDIO PLLC is a general practice dentist in Cleburne, 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. CLEBURNE DENTAL STUDIO PLLC NPI is 1952824468. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1607 W HENDERSON ST STE K
CLEBURNE, TX
ZIP 76033-179
Phone: (817) 522-3166

The provider's authorized official is Jin Park .
The authorized official title is Owner Dentist and has the following contact phone number (817) 522-3166.

The enumeration date for this NPI number is 7/18/2017 and was last updated on 7/21/2022.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice29792TEXASYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13427577MEDICAIDTEXAS

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: 11/21/2025

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