Organization Active NPI

Dental Guru PLLC Dba Signature Smiles Desoto

  • General Practice Dentistry
  • Desoto, TX
National Provider Identifier
1770288508
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL GURU PLLC DBA SIGNATURE SMILES DESOTO
Practice address
726 N Hampton Rd
Desoto, TX 75115-4510
Phone
(469) 643-4155
NPI assigned
Apr 3, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Authorized official

Name
Dr. Naren Mikkilineni, DMDNPI 1871726943
Title
Dentist Owner
Phone
(469) 643-4155

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

726 N Hampton Rd
Desoto, TX 75115-4510

Mailing address

726 N Hampton Rd
Desoto, TX 75115-4510
Phone (469) 643-4155

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1770288508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 N HAMPTON RD",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751154510",
            "telephone_number": "469-643-4155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 N HAMPTON RD",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751154510",
            "telephone_number": "469-643-4155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL GURU PLLC DBA SIGNATURE SMILES DESOTO",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-01",
        "status": "A",
        "authorized_official_last_name": "MIKKILINENI",
        "authorized_official_first_name": "NAREN",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "469-643-4155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; 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.