Mack Dental Clinic, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20885 Issued in TX

Legal business name

MACK DENTAL CLINIC, P.C.

Practice address

2521 Green Oak Drive
Carrollton, TX 75010

Phone

(214) 223-1856

NPI assigned

Jul 9, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Kyung S Lee, D.D.S.

Title

President

Phone

(214) 223-1856

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1247097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247097600000",
    "number": "1437388691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 MCKINNEY STREET",
            "address_2": "SUITE #100",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762094595",
            "telephone_number": "214-223-1856",
            "fax_number": "972-820-0372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 GREEN OAK DRIVE",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "75010",
            "telephone_number": "214-223-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACK DENTAL CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-09",
        "last_updated": "2009-07-09",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "KYUNG",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-223-1856",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Kyle Lytle, LPC
• Travis Maahs, DDS
• Caitlyn Marie Maaz
• Edna Mabuti, OTR/L
• Mackenzie Belle Machon, MS
• Jessica Macphee, PA-C
• Kelsey Alyssa Madenwald
• Srujana Madhavarapu, B.S
• Maftuna Kayumova MD PA
• Mahesh Gondi D.M.D. PLLC

• General Practice Dentistry in Carrollton, TX
• Providers in Carrollton, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2009; 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.