Mecca Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MECCA DENTAL PLLC

Practice address

12955 Main Street
Suite #100
Friso, TX 75035

Phone

(469) 920-8858

Fax

(469) 903-0005

NPI assigned

Aug 9, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Sulmaan Ahmed Farooqui, DDSNPI 1548595184

Title

Manager

Phone

(210) 725-4657

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sulmaan Ahmed Farooqui, DDS

  • General Practice Dentistry
  • Corpus Christi, TX
  • NPI 1548595184

  General Practice, TX

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1457034241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 RABBIT TRL",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750748333",
            "telephone_number": "210-725-4657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12955 MAIN STREET",
            "address_2": "SUITE #100",
            "city": "FRISO",
            "state": "TX",
            "postal_code": "75035",
            "telephone_number": "469-920-8858",
            "fax_number": "469-903-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MECCA DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-07",
        "status": "A",
        "authorized_official_last_name": "FAROOQUI",
        "authorized_official_first_name": "SULMAAN",
        "authorized_official_middle_name": "AHMED",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "210-725-4657",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.