Synergy Dental, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20761 Issued in TX

Legal business name

SYNERGY DENTAL, PLLC

Practice address

228 West Campbell Road
Richardson, TX 75080-3512

Phone

(972) 633-2377

Fax

(972) 633-2388

NPI assigned

Jun 8, 2006

Last updated

Mar 25, 2010By 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. Komson Sudhivoraseth, D.D.S.NPI 1730406075

Title

Dentist

Phone

(972) 633-2377

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Komson Sudhivoraseth, D.D.S.

  • General Practice Dentistry
  • Richardson, TX
  • NPI 1730406075
  NPD (past) Authorized official

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269475200000",
    "number": "1265472047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 WEST CAMPBELL ROAD",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803512",
            "telephone_number": "972-633-2377",
            "fax_number": "972-633-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 WEST CAMPBELL ROAD",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803512",
            "telephone_number": "972-633-2377",
            "fax_number": "972-633-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2010-03-25",
        "status": "A",
        "authorized_official_last_name": "SUDHIVORASETH",
        "authorized_official_first_name": "KOMSON",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "972-633-2377",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sylaza Kantamneni Medical PC
• Synaptic Pediatric Therapies, LLC. (Synaptic Pediatric Neuropsychology)
• Synaptic Pediatric Therapies, LLC.
• Synaptic Technologies PLLC
• Synergistic Health Systems LLC
• Amanda Somtochukwu Tabansi
• Margaret Ewube Tabe
• Carol McDowell Tackett, RNC, NNP
• Riaz Yusuf Tadia, M.D.
• Taha Care Transportation Inc

• General Practice Dentistry in Richardson, TX
• Providers in Richardson, 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 Mar 25, 2010; 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.