Magic Smiles PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

24348 Issued in TX

Legal business name

MAGIC SMILES PLLC

Practice address

1622 W Villa Maria Rd
Suite 140
Bryan, TX 77807-2311

Phone

(817) 451-4439

NPI assigned

Jan 25, 2017

Last updated

Jan 25, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gunjan Dhir

Title

Owner Dentist

Phone

(817) 451-4439

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485302400000",
    "number": "1699212951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1622 W VILLA MARIA RD",
            "address_2": "SUITE 140",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778072311",
            "telephone_number": "817-451-4439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 W VILLA MARIA RD",
            "address_2": "SUITE 140",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778072311",
            "telephone_number": "817-451-4439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGIC SMILES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-25",
        "last_updated": "2017-01-25",
        "status": "A",
        "authorized_official_last_name": "DHIR",
        "authorized_official_first_name": "GUNJAN",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "817-451-4439"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "24348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Bryan, TX
• Providers in Bryan, 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 Jan 25, 2017; 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.