Sprout Dentistry for Kids Allen, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

SPROUT DENTISTRY FOR KIDS ALLEN, PLLC

Doing business as

Sprout Dentistry for Kids

Practice address

939 W Stacy Rd Ste 140
Allen, TX 75013-5049

Phone

(469) 663-0098

Fax

(469) 663-0097

NPI assigned

Feb 23, 2022

Last updated

Jun 7, 2024By 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. Justin N Chan, DDSNPI 1144508292

Title

Pediatric Dentist/Partner

Phone

(469) 301-3212

Specialties & licenses 3

Addresses

Other names 1

• Sprout Dentistry for Kids Doing business as

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.

• Justin Nile Chan, DDS

  • Pediatric Dentistry
  • McKinney, TX
  • NPI 1144508292
  NPD Authorized official

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717718400000",
    "number": "1366198921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 W STACY RD STE 140",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750135049",
            "telephone_number": "469-663-0098",
            "fax_number": "469-663-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 W STACY RD STE 140",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750135049",
            "telephone_number": "469-663-0098",
            "fax_number": "469-663-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPROUT DENTISTRY FOR KIDS ALLEN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-23",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST/PARTNER",
        "authorized_official_telephone_number": "469-301-3212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sprout Dentistry for Kids",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sprout Dentistry for Kids",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.