Dental Provider Resources, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DENTAL PROVIDER RESOURCES, PLLC

Doing business as

Radiant Smiles

Practice address

1800 Brinker Rd
Ste 290
Denton, TX 76208-6176

Phone

(940) 382-1282

Fax

(940) 566-2495

NPI assigned

May 21, 2012

Organization subpart

No

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

Authorized official

Name

Jared Bruggeman, DDS

Title

Owner

Phone

(817) 328-6150

Specialties & licenses 1

Addresses

Other names 1

• Radiant Smiles Doing business as

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337558400000",
    "number": "1497015770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 TEXAN TRL",
            "address_2": "STE 229",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513776",
            "telephone_number": "817-328-6150",
            "fax_number": "866-882-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 BRINKER RD",
            "address_2": "STE 290",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762086176",
            "telephone_number": "940-382-1282",
            "fax_number": "940-566-2495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROVIDER RESOURCES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-21",
        "last_updated": "2012-05-21",
        "status": "A",
        "authorized_official_last_name": "BRUGGEMAN",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-328-6150",
        "authorized_official_credential": "DDS"
    },
    "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": "Radiant Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dem Counseling Services, LLC
• Jonathan Henry Demeter, MD
• Taylor Shae Denney, PT, DPT
• Richard Allen Denny Jr., PA C
• Dental Central
• Denton Acute Trauma PLLC
• Denton Allergy Group PLLC (Southwest Allergy & Asthma Center)
• Denton Anesthesiology Associates, PA
• Denton Apothecary, LP
• Denton Apothecary, LP (ReNue Rx #1- TELP)

• General Practice Dentistry in Denton, TX
• Providers in Denton, 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 May 21, 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.