Denton SHK Dental PC

Primary specialty

DentistTaxonomy code 122300000X

License

27677 Issued in TX

Legal business name

DENTON SHK DENTAL PC

Practice address

1800 Brinker Rd Ste 290
Denton, TX 76208-6179

Phone

(214) 736-3777

Fax

(972) 570-3776

NPI assigned

Jul 2, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sandy H Kim, KATIE BAE

Title

Office Manager

Phone

(214) 736-3777

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• 1st Smile Dental Care of Denton Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1013323732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 BRINKER RD STE 290",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762086179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 BRINKER RD STE 290",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762086179",
            "telephone_number": "214-736-3777",
            "fax_number": "972-570-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTON SHK DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-02",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SANDY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "214-736-3777",
        "authorized_official_credential": "KATIE BAE"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "27677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "298227402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "1st Smile Dental Care of Denton",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Denton Sleep Solutions, LLC
• Denton Sports & Physical Therapy
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• Denton Surgicare Partners LTD (Baylor Scott & White Surgicare - Denton)
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• Dentist in Denton, TX
• Providers in Denton, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.