Sisombath Dental PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SISOMBATH DENTAL PC

Practice address

210 S Preston Rd Ste 60
Prosper, TX 75078-2780

Phone

(469) 296-8714

NPI assigned

Jan 24, 2022

Organization subpart

No

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

Authorized official

Name

Jenny Sisombath, DDSNPI 1538511811

Title

President

Phone

(469) 296-8714

Specialties & licenses 1

Addresses

Other names 1

• Prosper & Smile Dental Care Doing business as

Locations

Practitioners 1

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

• Jenny Sisombath, D.D.S.

  • General Practice Dentistry
  • Euless, TX
  • NPI 1538511811
  NPD Authorized official

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

{
    "created_epoch": "1642982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642982400000",
    "number": "1760134480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5331 E MOCKINGBIRD LN APT 617",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752060911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S PRESTON RD STE 60",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750782780",
            "telephone_number": "469-296-8714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISOMBATH DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-24",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A",
        "authorized_official_last_name": "SISOMBATH",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-296-8714",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prosper & Smile Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Connie C Silvers
• Toinika Simmons
• Treasure Simmons
• Spencer Simons
• Singh Eye Surgical Specialists PLLC
• Amanda Skelton, APRN FNP-BC ANVP-BC
• Madeline Crank Slavens, PNP
• Small Victories Counseling
• Gregory Allen Smith, RBT
• Haley Smith

• Dental Clinic/Center in Prosper, TX
• Providers in Prosper, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; 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.