RADIANCE DENTISTRY NPI 1902105711

NPI Information

NPI: 1902105711
Provider Name: RADIANCE DENTISTRY
Classification: Dentist - 1223P0700X
Entity Type: Organization

Specialization: Prosthodontics

Address:
1235 KINWEST PKWY
IRVING, TX
ZIP 75063
Phone: (972) 258-1702
Get Directions

RADIANCE DENTISTRY is a prosthodontics dentist in Irving, TX. The provider is that branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. RADIANCE DENTISTRY NPI is 1902105711. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1235 KINWEST PKWY
IRVING, TX
ZIP 75063-403
Phone: (972) 258-1702
Fax: (972) 258-1703

The provider's authorized official is Mounir Iskandar .
The authorized official title is Dentist and has the following contact phone number (972) 258-1702.

The enumeration date for this NPI number is 3/18/2011 and was last updated on 11/23/2022.

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
1	1223G0001X	Dentist	General Practice	23921	TEXAS	No
2	1223P0700X	Dentist	Prosthodontics			Yes

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
1	27805703	MEDICAID	TEXAS

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: 5/5/2024

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