Maple Family Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

21968 Issued in TX

Legal business name

MAPLE FAMILY DENTAL PLLC

Practice address

4611 Columbia Ave
Suite 104
Dallas, TX 75226-2306

Phone

(214) 517-9608

Fax

(214) 827-8001

NPI assigned

Mar 7, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Mita Desai, DDS

Title

DDS, Owner

Phone

(214) 517-9608

Specialties & licenses 2

Addresses

Other names 1

• Columbia Dental and Orthodontics Doing business as

Locations

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

{
    "created_epoch": "1267920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267920000000",
    "number": "1750604609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 COLUMBIA AVE",
            "address_2": "SUITE 104",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752262306",
            "telephone_number": "214-517-9608",
            "fax_number": "214-827-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 COLUMBIA AVE",
            "address_2": "SUITE 104",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752262306",
            "telephone_number": "214-517-9608",
            "fax_number": "214-827-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE FAMILY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-07",
        "last_updated": "2010-03-07",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "MITA",
        "authorized_official_title_or_position": "DDS, OWNER",
        "authorized_official_telephone_number": "214-517-9608",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "21968",
            "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": "Columbia Dental and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shai Manzuri, MD
• Michelle Mao
• Orlinda Mapa, NP
• Roshni A Mapara
• Danisile Lucy Maphosa, ARNP
• Maples Enterprises, Inc.
• Maplewood Laboratories, LLC
• Maplewood Pharmacy
• Amy L Marable, PNP
• Miteshkumar Maradia

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2010; 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.