SGC Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SGC DENTAL LLC

Practice address

712 N Hampton Rd Ste 130
Desoto, TX 75115-4530

Phone

(972) 223-5500

Fax

(972) 223-5501

NPI assigned

Jan 27, 2020

Last updated

Jan 27, 2020By 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. Sixto Garduno Cogollor, DMDNPI 1245699974

Title

Owner

Phone

(972) 223-5500

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.

• Sixto Garduno Cogollor, DMD

  • General Practice Dentistry
  • Dallas, TX
  • NPI 1245699974
  NPD (past) Authorized official

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580083200000",
    "number": "1306477542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 N HAMPTON RD STE 130",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751154530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 N HAMPTON RD STE 130",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751154530",
            "telephone_number": "972-223-5500",
            "fax_number": "972-223-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SGC DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A",
        "authorized_official_last_name": "GARDUNO COGOLLOR",
        "authorized_official_first_name": "SIXTO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-223-5500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanna Scott, DC
• John Scroggins
• Adrienne Scull
• Lori Elizabeth Secerovic, NP
• Serenity Staffing, Inc
• Shafiey Dental Group PLLC (CFD Smile of Desoto)
• Alexander Shafiey, DMD
• Islam A Shahin, M.D.
• Brittney Shaw
• Latricia Lanell Shaw, LCSW

• Dentist in Desoto, TX
• Providers in Desoto, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.