Jupiter Dental Group PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

23791 Issued in TX

Legal business name

JUPITER DENTAL GROUP PLLC

Doing business as

Kids Dental Zone

Practice address

11000 Garland Rd
Dallas, TX 75218-2615

Phone

(214) 328-4867

NPI assigned

Oct 1, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Steven Coffman, DMD

Title

President

Phone

(702) 300-7886

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kids Dental Zone Doing business as

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393372800000",
    "number": "1033546320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 939",
            "city": "LAKE DALLAS",
            "state": "TX",
            "postal_code": "750650939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11000 GARLAND RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752182615",
            "telephone_number": "214-328-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUPITER DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-01",
        "last_updated": "2014-02-26",
        "status": "A",
        "authorized_official_last_name": "COFFMAN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-300-7886",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205190609",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kids Dental Zone",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shelby Jungers, RD, LD
• Sarah Katharina Jungnitsch
• Michael John Madison Junior
• Marisa M Juntilla, MD, PHD
• Rohan Kumar Jupelly
• Jupiter Medical Services, PA
• Gay E. Jurgens, M.S.S.W.
• Christopher Stephen Jurma, PHARMD
• Jane Ossa Jurugo, MS, RDN, LD
• Daniel Ramirez Jusayan

• General Practice Dentistry in Dallas, TX
• Providers in Dallas, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.