Southridge Dental, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

18977 Issued in TX

Legal business name

SOUTHRIDGE DENTAL, LLC

Practice address

3303 Unicorn Lake Blvd
Ste 200
Denton, TX 76210

Phone

(940) 566-4942

Fax

(940) 381-0815

NPI assigned

Sep 14, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Tyrone Dunson II, DDSNPI 1023227212

Title

Owner/Dentist

Phone

(940) 566-4942

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tyrone Dunson II, D.D.S.

  • General Practice Dentistry
  • Denton, TX
  • NPI 1023227212
  NPD (past) Authorized official

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

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505347200000",
    "number": "1740709344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 UNICORN LAKE BLVD",
            "address_2": "STE 200",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "76210",
            "telephone_number": "940-566-4942",
            "fax_number": "940-381-0815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 UNICORN LAKE BLVD",
            "address_2": "STE 200",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "76210",
            "telephone_number": "940-566-4942",
            "fax_number": "940-381-0815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHRIDGE DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-14",
        "last_updated": "2017-09-14",
        "status": "A",
        "authorized_official_last_name": "DUNSON",
        "authorized_official_first_name": "TYRONE",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "940-566-4942",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "18977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Soto, BCABA
• Ivette F Soto, DDS
• Rafeal Soto
• Linda Bussey Southard, LCDC
• Southerncare, Inc. (SouthernCare Denton)
• Span, Inc
• Span, Incorporated (Span Denton County)
• Specialeyes Optical, LLC
• Spectrum Vision, PLLC
• Speech Solutions

• Dentist in Denton, TX
• Providers in Denton, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.