NPIMap

Organization Active NPI

Nisha Liz John P.L.L.C

Doing business as Big Grin Dental

  • General Practice Dentistry
  • Garland, TX
National Provider Identifier
1124478375
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
28575 Issued in TX
Legal business name
NISHA LIZ JOHN P.L.L.C
Doing business as
Big Grin Dental
Practice address
3046 Lavon Drive
Suite 125,127
Garland, TX 75040
Phone
(803) 446-2831
NPI assigned
Jun 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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

Authorized official

Name
Dr. Nisha Liz John, DDSNPI 1669776464
Title
President
Phone
(803) 446-2831

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 28575 TX Primary

Addresses

Primary practice location

3046 Lavon Drive
Suite 125,127
Garland, TX 75040

Mailing address

12040 Ashaway Lane
Frisco, TX 75035
Phone (803) 446-2831

Other names 1

  • Big Grin Dental Doing business as

National Provider Directory

National Provider Directory

Locations

3046 Lavon Dr
Ste 125127
Garland, TX 75040
Phone (803) 446-2831

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466380800000",
    "number": "1124478375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12040 ASHAWAY LANE",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75035",
            "telephone_number": "803-446-2831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3046 LAVON DRIVE",
            "address_2": "SUITE 125,127",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "75040",
            "telephone_number": "803-446-2831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NISHA LIZ JOHN P.L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-06-20",
        "status": "A",
        "authorized_official_last_name": "JOHN",
        "authorized_official_first_name": "NISHA",
        "authorized_official_middle_name": "LIZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-446-2831",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "28575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Big Grin Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Garland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; 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.