Pecan Dental and Implant Solutions LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PECAN DENTAL AND IMPLANT SOLUTIONS LLC

Practice address

670 W Campbell Rd
Richardson, TX 75080-3393

Phone

(414) 630-7384

NPI assigned

Mar 15, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Osama Siddiqui, DMDNPI 1811506876

Title

Owner

Phone

(469) 781-0231

Specialties & licenses 2

Addresses

Other names 1

• Smile Makeover Doing business as

Locations

Practitioners 1

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

• Osama Mohammad Siddiqui, DMD

  • General Practice Dentistry
  • Richardson, TX
  • NPI 1811506876
  NPD Authorized official

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700006400000",
    "number": "1578148201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 W CAMPBELL RD",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803393",
            "telephone_number": "414-630-7384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 W CAMPBELL RD",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803393",
            "telephone_number": "414-630-7384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECAN DENTAL AND IMPLANT SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-15",
        "last_updated": "2023-11-15",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUI",
        "authorized_official_first_name": "OSAMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-781-0231",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Makeover",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Jonathan Pearlman, D.C.
• Alisha Condron Pearson, M.S.,CCC-SLP
• Jamie Rebekah Pearson, B.S., M.S., C.N.I.M
• James D Peck, DDS
• Kristin Marie Peckman, MS, EIS
• Samantha Marie Pecson, COTA
• Pedi Spot Home, LLC
• Pedi Spot, LLC

• Dentist in Richardson, TX
• Providers in Richardson, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; 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.