DFW Dental Team

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

DFW DENTAL TEAM

Practice address

5744 LBJ Fwy
Dallas, TX 75240-6322

Phone

(713) 481-9500

NPI assigned

Jan 26, 2016

Last updated

Jun 9, 2021By 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

Ketan Sukkawala

Title

Owner

Phone

(979) 450-1116

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623196800000",
    "number": "1427415116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5744 LBJ FWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752406322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5744 LBJ FWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752406322",
            "telephone_number": "713-481-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3055 Bardin Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Grand Prairie",
            "state": "TX",
            "postal_code": "750523819",
            "country_code": "US",
            "telephone_number": "214-412-1500",
            "fax_number": "214-466-1045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DFW DENTAL TEAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-26",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A",
        "authorized_official_last_name": "SUKKAWALA",
        "authorized_official_first_name": "KETAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "979-450-1116"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DFW Concierge MD PLLC
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• DFW Dental Associates, PA (Frysh Dental Group)
• DFW Dental Specialists PLLC
• DFW Family Chiropractic PA
• DFW FDC-Redbird PLLC (Wow Dental)
• DFW FTBC 1 LLC
• DFW in-Home ABA, LLC
• DFW Injury & Rehab Center, P.a.

• Pediatric Dentistry in Dallas, TX
• Providers in Dallas, 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 9, 2021; 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.