Southern Star Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22606 Issued in TX

Legal business name

SOUTHERN STAR DENTAL

Practice address

201 E Bethany Dr
Ste 20
Allen, TX 75002-3800

Phone

(214) 383-4600

Fax

(214) 383-4601

NPI assigned

Aug 10, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Pennie Moreland, DDS

Title

Owner

Phone

(214) 383-4600

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470787200000",
    "number": "1548714371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E BETHANY DR",
            "address_2": "STE 20",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750023800",
            "telephone_number": "214-383-4600",
            "fax_number": "214-383-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E BETHANY DR",
            "address_2": "STE 20",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750023800",
            "telephone_number": "214-383-4600",
            "fax_number": "214-383-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN STAR DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-10",
        "last_updated": "2016-08-10",
        "status": "A",
        "authorized_official_last_name": "MORELAND",
        "authorized_official_first_name": "PENNIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-383-4600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandi Soliz, RD, LD, CDE
• Virginia Claire Sooter, APRN-CNP
• Jose Soria
• South Med Supplies LLC
• Southern Charm Pediatrics
• Southlake Doctors Express, PA PSC
• Carla June Spann, DDS
• Sparrow Infusion Team, PLLC
• Specialty Infusion LLC
• Spectrum Behavioral Solutions LLC

• General Practice Dentistry in Allen, TX
• Providers in Allen, 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 Aug 10, 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.