Andrew Eugene Pak, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

38130 Issued in TX

Practice address

2317 W University Dr Ste 149
Denton, TX 76201-1613

Phone

(940) 566-0127

NPI assigned

Jun 23, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Affordable Dentures & Implants - Texas, PLLC

  • General Practice Dentistry
  • Lewisville, TX
  • NPI 1053568238
  NPD (past)
• Dentists of Vail, LLP

  • Dentist
  • Vail, AZ
  • NPI 1457814063
  NPD (past)
• Signal Butte Kids Dentistry and Orthodontics, LLP

  • Dentist
  • Mesa, AZ
  • NPI 1588200265
  NPD (past)

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1215553565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12013 DRAIN DR",
            "city": "NEWARK",
            "state": "TX",
            "postal_code": "760718948",
            "telephone_number": "682-554-1648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2317 W UNIVERSITY DR STE 149",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762011613",
            "telephone_number": "940-566-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAK",
        "first_name": "ANDREW",
        "middle_name": "EUGENE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-23",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D010719",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "38130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• P3 Duesing Incorporated
• Devorah Pachtman
• Pacific Labs, LLC
• Samuel Jacob Page
• Pain Relief Management PC
• Joanna Kristine Palavicini, NP-C, APRN
• Sree L Palchuru, M.D.
• Jennifer Anne Palcich, M.A., LPC
• Charles W Paley, MD
• Palmer Edge Chiropractic, LLC

• General Practice Dentistry in Denton, TX
• Providers in Denton, 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 Apr 7, 2022; 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.