Carly Allen, DDS
Individual provider Active NPI Dentist · Plano, TX
NPI 1013528025 · NPPES record last updated Jun 24, 2023
Key facts
- NPI
- 1013528025
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 36429 (TX)
- Practice address
- 3604 Preston Rd Ste 400
Plano, TX 75093-8630 - Phone
- (972) 312-0000
- NPI assigned
- Aug 12, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36429 | TX | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heather Hagen DDS & Miranda Lacy DDS | Dentist | Past |
Accepting new patients |
| Ideal Dental and Orthodontics | Past |
Accepting new patients | |
| Ideal Dental of Garland PLLC | Dentist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 36429 | TX | Yes |
Addresses
Primary practice location
3604 Preston Rd Ste 400
Plano, TX 75093-8630
Mailing address
7041 Town North Dr
Dallas, TX 75231-7303
Phone (479) 221-8529
Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.