KB Dental Plano P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21085 Issued in TX

Legal business name

KB DENTAL PLANO P.A.

Doing business as

Southfork Dental

Practice address

7924 Preston Rd
Plano, TX 75024-2355

Phone

(972) 544-4800

NPI assigned

Aug 29, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Bindu Kolli, DMD

Title

Dentist

Phone

(972) 544-4800

Specialties & licenses 1

Addresses

Other names 1

• SOUTHFORK DENTAL Doing business as

Locations

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535500800000",
    "number": "1740761550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 ORIOLE DR",
            "city": "MURPHY",
            "state": "TX",
            "postal_code": "750943887",
            "telephone_number": "972-544-4800",
            "fax_number": "972-739-9137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7924 PRESTON RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750242355",
            "telephone_number": "972-544-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KB DENTAL PLANO P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-29",
        "last_updated": "2018-08-29",
        "status": "A",
        "authorized_official_last_name": "KOLLI",
        "authorized_official_first_name": "BINDU",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "972-544-4800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHFORK DENTAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SOUTHFORK DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Omotolani Esther Kayode, NONE
• Faris Kayssi, FNP
• Maftuna Kayumova, MD
• Mansoor Ahmed Kazi, FNP-C
• Syed Saad Kazmi
• KD Beyer and Associates
• KDDS Dental PA (Innate Dental Solutions)
• Kendall Elizabeth Keane, BCBA
• Michelle Kearby, MS, LPC
• Janna Kearns, PT

• General Practice Dentistry in Plano, TX
• Providers in Plano, 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 Aug 29, 2018; 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.