NPIMap

Organization Active NPI

Ismile Family Dental PA

  • General Practice Dentistry
  • Irving, TX
National Provider Identifier
1477808442
Registry record updated Jul 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23445 Issued in TX
Legal business name
ISMILE FAMILY DENTAL PA
Practice address
825 West Royal Lane
Ste 210
Irving, TX 75039
Phone
(214) 620-7445
NPI assigned
Jul 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2012

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

Authorized official

Name
Dr. Sujatha Tella, DDSNPI 1962609370
Title
Director
Phone
(214) 620-7445

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 23445 TX Primary

Addresses

Primary practice location

825 West Royal Lane
Ste 210
Irving, TX 75039

Mailing address

108 San Gabriel Dr
Irving, TX 75039-3350
Phone (214) 620-7445

National Provider Directory

National Provider Directory

Locations

825 W Royal Ln
Ste 210
Irving, TX 75039
Phone (214) 496-0626

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342483200000",
    "number": "1477808442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 SAN GABRIEL DR",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750393350",
            "telephone_number": "214-620-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 WEST ROYAL LANE",
            "address_2": "STE 210",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "75039",
            "telephone_number": "214-620-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISMILE FAMILY DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-17",
        "last_updated": "2012-07-17",
        "status": "A",
        "authorized_official_last_name": "TELLA",
        "authorized_official_first_name": "SUJATHA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "214-620-7445",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; 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.