SPK Family Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SPK FAMILY DENTAL PLLC

Doing business as

Carrier Family Dental

Practice address

355 E Westchester Pkwy Ste 200
Grand Prairie, TX 75052-2846

Phone

(972) 546-3888

NPI assigned

Jul 11, 2014

Organization subpart

No

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

Authorized official

Name

Harita Kodali, DMD

Title

Owner/Provider

Phone

(972) 546-3888

Specialties & licenses 1

Addresses

Other names 1

• Carrier Family Dental Doing business as

Locations

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

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405036800000",
    "number": "1730595612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 E WESTCHESTER PKWY STE 200",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750522846",
            "telephone_number": "972-546-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 E WESTCHESTER PKWY STE 200",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750522846",
            "telephone_number": "972-546-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPK FAMILY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-11",
        "last_updated": "2014-07-11",
        "status": "A",
        "authorized_official_last_name": "KODALI",
        "authorized_official_first_name": "HARITA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "972-546-3888",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carrier Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2014; 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.