NPIMap

Organization Active NPI

Children's Dental at Preston Trail, PC

Doing business as Park Place Pediatric Dentistry and Orthodontics

  • Pediatric Dentistry
  • Arlington, TX
National Provider Identifier
1720844111
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
CHILDREN'S DENTAL AT PRESTON TRAIL, PC
Doing business as
Park Place Pediatric Dentistry and Orthodontics
Practice address
3602 Matlock Rd Ste 208
Arlington, TX 76015-3600
Phone
(817) 465-1888
NPI assigned
Feb 23, 2024
Organization subpart
Yes
Parent organization
CHILDREN'S DENTAL AT PRESTON TRAIL, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Authorized official

Name
Charlotte Dasch
Title
Director of Cred and PR
Phone
(504) 638-0303

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X Primary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X

Addresses

Primary practice location

3602 Matlock Rd Ste 208
Arlington, TX 76015-3600

Mailing address

1610 54TH Ave N Ste 205
Nashville, TN 37209-1442
Phone (615) 678-0759

Other names 1

  • Park Place Pediatric Dentistry and Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Children's Dental at Preston Trail PC3 organizations share this tax ID, including this one
Part of
Children's Dental at Preston Trail PC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3602 Matlock Rd
Ste 208
Arlington, TX 76015
Phone (817) 465-1888

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

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": "1708646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1720844111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 54TH AVE N STE 205",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372091442",
            "telephone_number": "615-678-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3602 MATLOCK RD STE 208",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760153600",
            "telephone_number": "817-465-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S DENTAL AT PRESTON TRAIL, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDREN'S DENTAL AT PRESTON TRAIL, PC",
        "enumeration_date": "2024-02-23",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A",
        "authorized_official_last_name": "DASCH",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "DIRECTOR OF CRED AND PR",
        "authorized_official_telephone_number": "504-638-0303"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Place Pediatric Dentistry and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; 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.