Southlake Dental Care, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20397 Issued in TX

Legal business name

SOUTHLAKE DENTAL CARE, PA

Practice address

500 W Southlake Blvd
Ste 130
Southlake, TX 76092-6165

Phone

(817) 310-0310

Fax

(817) 310-0909

NPI assigned

Feb 20, 2008

Last updated

Feb 20, 2008By 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. Todd Gathright, D.D.S.

Title

President

Phone

(817) 991-9478

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1477721728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W SOUTHLAKE BLVD",
            "address_2": "STE 130",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926165",
            "telephone_number": "817-310-0310",
            "fax_number": "817-310-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W SOUTHLAKE BLVD",
            "address_2": "STE 130",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926165",
            "telephone_number": "817-310-0310",
            "fax_number": "817-310-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAKE DENTAL CARE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "GATHRIGHT",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-991-9478",
        "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": "20397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laverna Soucie
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• Southlake Child and Family Therapy
• Southlake Childrens Sleep Center, LTD
• Southlake Chiropractic Clinic
• Southlake Diagnostics Inc
• Southlake Diagnostics Inc
• Southlake Doctors Express, PA PSC (AFC Urgent Care)
• Southlake Emergicare PLLC
• Southlake Endocrinology, PLLC

• General Practice Dentistry in Southlake, TX
• Providers in Southlake, 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 Feb 20, 2008; 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.