Millennium Smiles

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

28879 Issued in TX

Legal business name

MILLENNIUM SMILES

Practice address

8979 Farm to Market Rd 423 Suite 400
Frisco, TX 75034
UM

Phone

(972) 987-4899

Fax

(972) 987-4915

NPI assigned

Dec 27, 2016

Organization subpart

No

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

Authorized official

Name

Dunia Korous, DDS, FICOI

Title

Owner/Dentist

Phone

(972) 987-4899

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• So Hyeon Park, DDS

  • Dentist
  • Frisco, TX
  • NPI 1700491230
  NPD (past)

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

{
    "created_epoch": "1482796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482796800000",
    "number": "1487199667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8979 FM 423",
            "address_2": "SUITE 400",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75034",
            "telephone_number": "972-987-4899",
            "fax_number": "972-987-4915"
        },
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "LOCATION",
            "address_type": "FGN",
            "address_1": "8979 FARM TO MARKET RD 423 SUITE 400",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75034",
            "telephone_number": "972-987-4899",
            "fax_number": "972-987-4915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLENNIUM SMILES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-27",
        "last_updated": "2016-12-27",
        "status": "A",
        "authorized_official_last_name": "KOROUS",
        "authorized_official_first_name": "DUNIA",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "972-987-4899",
        "authorized_official_credential": "DDS, FICOI"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "28879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH CARE INSURANCE COMPANIES",
            "identifier": "1134566052",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; 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.