NPIMap

Organization Active NPI

Prident Dental Associates, P.C.

Doing business as Wisdom Dental

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1114394350
Registry record updated Aug 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PRIDENT DENTAL ASSOCIATES, P.C.
Doing business as
Wisdom Dental
Practice address
1028 W Camp Wisdom Rd
Dallas, TX 75232-3536
Phone
(972) 362-2223
NPI assigned
Aug 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2015

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

Authorized official

Name
Harry J Blanek
Title
Owner/ Dental Director
Phone
(972) 362-2223

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1028 W Camp Wisdom Rd
Dallas, TX 75232-3536

Mailing address

15110 Dallas Pkwy
Suite 470
Dallas, TX 75248-4635

Other names 1

  • Wisdom Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Prident Dental Associates PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1028 W Camp Wisdom Rd
Dallas, TX 75232
Phone (972) 362-2223

NPI Registry JSON

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440374400000",
    "number": "1114394350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15110 DALLAS PKWY",
            "address_2": "SUITE 470",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752484635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 W CAMP WISDOM RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752323536",
            "telephone_number": "972-362-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIDENT DENTAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-24",
        "last_updated": "2015-08-24",
        "status": "A",
        "authorized_official_last_name": "BLANEK",
        "authorized_official_first_name": "HARRY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/ DENTAL DIRECTOR",
        "authorized_official_telephone_number": "972-362-2223"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wisdom Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; 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.