NPIMap

Organization Active NPI

Stonelake Family Dentistry PLLC

Doing business as Stonelake Family Dentistry

  • General Practice Dentistry
  • Frisco, TX
National Provider Identifier
1306298831
Registry record updated Jul 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
28118 Issued in TX
Legal business name
STONELAKE FAMILY DENTISTRY PLLC
Doing business as
Stonelake Family Dentistry
Practice address
14550 SH 121
Ste 100
Frisco, TX 75035
Phone
(512) 785-2680
Fax
(866) 892-0774
NPI assigned
Jul 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2016

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

Authorized official

Name
Mr. Martin Pak, DDSNPI 1073868402
Title
Owner
Phone
(512) 785-2680

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: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 28118 TX Primary

Addresses

Primary practice location

14550 SH 121
Ste 100
Frisco, TX 75035

Mailing address

14550 SH 121
Ste 100
Frisco, TX 75035
Phone (512) 785-2680

Other identifiers 1

IdentifierTypeStateIssuer
1073868402OtherTXNPI TYPE 1

Other names 1

  • Stonelake Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

14550 State Highway 121
Ste 100
Frisco, TX 75035
Phone (214) 494-4246

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467936000000",
    "number": "1306298831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14550 SH 121",
            "address_2": "STE 100",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75035",
            "telephone_number": "512-785-2680",
            "fax_number": "866-892-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14550 SH 121",
            "address_2": "STE 100",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75035",
            "telephone_number": "512-785-2680",
            "fax_number": "866-892-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONELAKE FAMILY DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-08",
        "last_updated": "2016-07-08",
        "status": "A",
        "authorized_official_last_name": "PAK",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-785-2680",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "28118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1073868402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stonelake Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.