Firewheel Pediatric Dental Specialists PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

30555 Issued in TX

Legal business name

FIREWHEEL PEDIATRIC DENTAL SPECIALISTS PLLC

Practice address

4880 N President George Bush Hwy Ste 104
Garland, TX 75040

Phone

(972) 364-7472

NPI assigned

Apr 19, 2018

Last updated

Aug 17, 2018By 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

Maheeb Jaouni, DDS, MS

Title

Owner

Phone

(469) 702-0286

Specialties & licenses 1

Addresses

Other names 1

• Firewheel Pediatric Dental Specialists PLLC Other name

Locations

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1356838981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4880 N PRESIDENT GEORGE BUSH HWY STE 104",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750402742",
            "telephone_number": "972-364-7472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4880 N PRESIDENT GEORGE BUSH HWY STE 104",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "75040",
            "telephone_number": "972-364-7472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIREWHEEL PEDIATRIC DENTAL SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-19",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "JAOUNI",
        "authorized_official_first_name": "MAHEEB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-702-0286",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "30555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Firewheel Pediatric Dental Specialists PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Leo L Fitzgerald Jr., MD

• Pediatric Dentistry in Garland, TX
• Providers in Garland, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.