NPIMap

Organization Active NPI

Dental Distinction, PLLC

  • Dentist
  • Plano, TX
National Provider Identifier
1770929887
Registry record updated May 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
24193 Issued in TX
Legal business name
DENTAL DISTINCTION, PLLC
Practice address
609 W 15TH St
Suite# 130
Plano, TX 75075-8876
Phone
(972) 423-3322
NPI assigned
May 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2013

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

Authorized official

Name
Mohammed Mansour, DDS, MS
Title
Owner
Phone
(469) 230-7338

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 24193 TX Primary
Oral and Maxillofacial Pathology DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0106X
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223X0400X

Addresses

Primary practice location

609 W 15TH St
Suite# 130
Plano, TX 75075-8876

Mailing address

609 W 15TH Street
Suite# 130
Plano, TX 75075
Phone (972) 423-3322

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368576000000",
    "number": "1770929887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 W 15TH STREET",
            "address_2": "SUITE# 130",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75075",
            "telephone_number": "972-423-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 W 15TH ST",
            "address_2": "SUITE# 130",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750758876",
            "telephone_number": "972-423-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL DISTINCTION, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-15",
        "last_updated": "2013-05-15",
        "status": "A",
        "authorized_official_last_name": "MANSOUR",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-230-7338",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "24193",
            "primary": true
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; 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.