Cosmic Dental PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

COSMIC DENTAL PLLC

Practice address

1502 S Westmoreland Rd
Dallas, TX 75211-5765

Phone

(904) 729-2866

NPI assigned

Sep 21, 2023

Last updated

Oct 23, 2023By 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

Serge Mechrek

Title

Authorized Official

Phone

(904) 729-2866

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.

• Serge Bou Mechrek

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Dallas, TX
  • NPI 1366059388
  NPD

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

{
    "created_epoch": "1695254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698019200000",
    "number": "1275312068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 S WESTMORELAND RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752115765",
            "telephone_number": "904-729-2866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 S WESTMORELAND RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752115765",
            "telephone_number": "904-729-2866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSMIC DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-21",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A",
        "authorized_official_last_name": "MECHREK",
        "authorized_official_first_name": "SERGE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "904-729-2866"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Tait Cosens, MSC, NCC, LCDC
• Jai Cosey
• Cassidy Ann Cosgrove, PHARMACIST
• Lucina Cosio
• Cosmetic Surgical Center PA (Cosmetic Surgical Center)
• Cosmo Investment Group, PLLC (Highland Park Allergy and Asthma Specialists)
• Cosmos Hospice LLC
• Joao Paulo Costa Coelho
• Gustavo Costa Medeiros, MD
• Ada Milagros Costa, LCSW

• Orthodontics and Dentofacial Orthopedics Dentistry in Dallas, TX
• Providers in Dallas, TX by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.