NPIMap

Organization Active NPI

Dental Delite PG PA

Doing business as Dental Delite

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1700665601
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL DELITE PG PA
Doing business as
Dental Delite
Practice address
8222 Bruton Rd
Dallas, TX 75217-1902
Phone
(214) 398-1234
Fax
(866) 610-0446
NPI assigned
Sep 28, 2023
Last updated
Sep 28, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL DELITE PG PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Authorized official

Name
Dominique Valladarez
Title
General Manager
Phone
(214) 398-1234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

8222 Bruton Rd
Dallas, TX 75217-1902

Mailing address

PO Box 172198
Dallas, TX 75217-1108
Phone (214) 398-1234

Other practice location 1

938 E Highway 67
Duncanville, TX 75137-2706
Phone (972) 572-5990

Other identifiers 3

IdentifierTypeStateIssuer
1497443980MedicaidTX
1346978376MedicaidTX
1477937167MedicaidTX

Other names 1

  • Dental Delite Doing business as

National Provider Directory

National Provider Directory
Part of
Dental Delite PG PA

Locations

8222 Bruton Rd
Dallas, TX 75217
Phone (214) 398-1234

938 E Highway 67
Duncanville, TX 75137
Phone (972) 572-5990

Practitioners & affiliated clinicians

Practitioners 6

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": "1695859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1700665601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 172198",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752171108",
            "telephone_number": "214-398-1234",
            "fax_number": "866-610-0446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8222 BRUTON RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752171902",
            "telephone_number": "214-398-1234",
            "fax_number": "866-610-0446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "938 E Highway 67",
            "address_purpose": "LOCATION",
            "city": "Duncanville",
            "state": "TX",
            "postal_code": "751372706",
            "country_code": "US",
            "telephone_number": "972-572-5990",
            "fax_number": "866-610-0446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DENTAL DELITE PG PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL DELITE PG PA",
        "enumeration_date": "2023-09-28",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-26",
        "status": "A",
        "authorized_official_last_name": "VALLADAREZ",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "214-398-1234"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497443980",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346978376",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477937167",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Delite",
            "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 Sep 28, 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.