Trophy Dental PA

Primary specialty

DentistTaxonomy code 122300000X

License

18141 Issued in TX

Legal business name

TROPHY DENTAL PA

Practice address

301 Trophy Lake Dr
Ste 120
Trophy Club, TX 76262

Phone

(817) 854-0360

Fax

(817) 490-9029

NPI assigned

Sep 13, 2006

Organization subpart

No

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

Authorized official

Name

N Debbie Nguyen Sudbrook, DDS

Title

Part Owner

Phone

(817) 854-0360

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790880904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 TROPHY LAKE DR",
            "address_2": "STE 120",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "76262",
            "telephone_number": "817-854-0360",
            "fax_number": "817-490-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 TROPHY LAKE DR",
            "address_2": "STE 120",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "76262",
            "telephone_number": "817-854-0360",
            "fax_number": "817-490-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TROPHY DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SUDBROOK",
        "authorized_official_first_name": "N DEBBIE",
        "authorized_official_middle_name": "NGUYEN",
        "authorized_official_title_or_position": "PART OWNER",
        "authorized_official_telephone_number": "817-854-0360",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "18141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trophy Club Medical Services, LLP
• Trophy Club Pediatrics PA
• Trophy Club Smiles PLLC
• Trophy Club Vision Care LLP
• Trophy Club Vision Care PLLC
• Trophy Smile Studio
• True Medicine, PA
• Tyler Oral & Facial Surgery Inc.
• Oluchi Ijeoma Uwajumogu, NP 1051106
• Walgreen Co

• Dentist in Trophy Club, TX
• Providers in Trophy Club, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.