GP Family Dentistry PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21422 Issued in TX

Legal business name

GP FAMILY DENTISTRY PLLC

Practice address

117 N Belt Line Rd
Grand Prairie, TX 75050-5800

Phone

(972) 262-1395

Fax

(972) 262-1397

NPI assigned

Dec 6, 2013

Organization subpart

No

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

Authorized official

Name

Soo Bin Kim, DDS

Title

Owner/ Dentist

Phone

(404) 354-6787

Specialties & licenses 1

Addresses

Other names 1

• KREST DENTAL Doing business as

Locations

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

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386288000000",
    "number": "1104257880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 543248",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750543248",
            "telephone_number": "972-262-1395",
            "fax_number": "972-262-1397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 N BELT LINE RD",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750505800",
            "telephone_number": "972-262-1395",
            "fax_number": "972-262-1397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GP FAMILY DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-06",
        "last_updated": "2013-12-06",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SOO",
        "authorized_official_middle_name": "BIN",
        "authorized_official_title_or_position": "OWNER/ DENTIST",
        "authorized_official_telephone_number": "404-354-6787",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KREST DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cynthia L Gonzalez
• Jaime Rene Gonzalez, O.D.
• Good Hands Care Home Health Services, Inc
• Jennifer Allison Gorman, MS, CCC-SLP
• Nasheena Sharelle Gover, LCSW
• GP Medical Management Group Inc
• Grace Covenant Home Health Care of Texas LLC
• Kristen Lynn Graf, OTR
• Annette Graham
• Grand Prairie Advanced Eyecare Inc

• General Practice Dentistry in Grand Prairie, TX
• Providers in Grand Prairie, 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 Dec 6, 2013; 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.