Peridot Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PERIDOT DENTAL PLLC

Practice address

3616 S Lancaster Rd
Dallas, TX 75216-5629

Phone

(214) 374-7100

NPI assigned

Aug 29, 2020

Last updated

Aug 29, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Oluleke Jeboda, DMDNPI 1124036173

Title

Owner

Phone

(217) 801-1439

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Oluleke S Jeboda, D.M.D,

  • General Practice Dentistry
  • Dallas, TX
  • NPI 1124036173
  NPD Authorized official
• Christopher Yakubu Emuedue, DMD

  • General Practice Dentistry
  • Dallas, TX
  • NPI 1043392996
  NPD (past)

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

{
    "created_epoch": "1598659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598659200000",
    "number": "1083227904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3616 S LANCASTER RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752165629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3616 S LANCASTER RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752165629",
            "telephone_number": "214-374-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIDOT DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-29",
        "last_updated": "2020-08-29",
        "certification_date": "2020-08-29",
        "status": "A",
        "authorized_official_last_name": "JEBODA",
        "authorized_official_first_name": "OLULEKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-801-1439",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yaritza Perez
• Yoheli Perez, PT
• Zoany Perez, M.S., LPC
• Performance Sports Medicine, Inc.
• Alyssa Nicole Peri, IBCLC
• Peridot Enterprises LLC
• Navoda Perikala
• Kimberly Periman, CNIM
• Perioperative and Internal Medicine Group PLLC (Texas Psychiatry Consultants)
• Perioperative and Internal Medicine Group PLLC

• Dental Clinic/Center in Dallas, TX
• Providers in Dallas, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2020; 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.