NPIMap

Organization Active NPI

Oak Cliff Childrens Dentist PLLC

Doing business as Oak Cliff Childrens Dentist

  • Pediatric Dentistry
  • Dallas, TX
National Provider Identifier
1619276185
Registry record updated Mar 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
22791 Issued in TX
Legal business name
OAK CLIFF CHILDRENS DENTIST PLLC
Doing business as
Oak Cliff Childrens Dentist
Practice address
400 N Zang Blvd
Ste 100
Dallas, TX 75208-4447
Phone
(214) 390-9960
Fax
(214) 390-9961
NPI assigned
Mar 22, 2011
Last updated
Mar 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2012

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

Authorized official

Name
Dr. Suneetha Boppana, D.D.S.NPI 1578784732
Title
Managing Member
Phone
(214) 390-9960

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 22791 TX Primary

Addresses

Primary practice location

400 N Zang Blvd
Ste 100
Dallas, TX 75208-4447

Mailing address

400 N Zang Blvd
Ste 100
Dallas, TX 75208-4447
Phone (214) 390-9960

Other names 1

  • Oak Cliff Childrens Dentist Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332201600000",
    "number": "1619276185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N ZANG BLVD",
            "address_2": "STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752084447",
            "telephone_number": "214-390-9960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N ZANG BLVD",
            "address_2": "STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752084447",
            "telephone_number": "214-390-9960",
            "fax_number": "214-390-9961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK CLIFF CHILDRENS DENTIST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-22",
        "last_updated": "2012-03-20",
        "status": "A",
        "authorized_official_last_name": "BOPPANA",
        "authorized_official_first_name": "SUNEETHA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "214-390-9960",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "22791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oak Cliff Childrens Dentist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.