Sparkle Dentistry Grand PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SPARKLE DENTISTRY GRAND PLLC

Practice address

3122 Spencer Hwy
Suite 170
Pasadena, TX 77504-1155

Phone

(713) 470-0954

NPI assigned

May 14, 2012

Organization subpart

No

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

Authorized official

Name

Sarabjit K. Khassa, D.D.S.

Title

President

Phone

(214) 775-9524

Specialties & licenses 1

Addresses

Other names 1

• Sedation Dental Doing business as

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457308800000",
    "number": "1487913216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15110 N. DALLAS PKWY.",
            "address_2": "STE. 470",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3122 SPENCER HWY",
            "address_2": "SUITE 170",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775041155",
            "telephone_number": "713-470-0954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARKLE DENTISTRY GRAND PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-14",
        "last_updated": "2016-03-07",
        "status": "A",
        "authorized_official_last_name": "KHASSA",
        "authorized_official_first_name": "SARABJIT",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-775-9524",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sedation Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.