NPIMap

Organization Active NPI

Yoon K Tak DMD a Professional Corporation

  • Pediatric Dentistry
  • Grand Prairie, TX
National Provider Identifier
1801040993
Registry record updated Jul 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
23670 Issued in TX
Legal business name
YOON K TAK DMD A PROFESSIONAL CORPORATION
Doing business as
Grand prairieChildrens Dentistry
Practice address
5115 Lakeridge Parkway
#200
Grand Prairie, TX 75052
Phone
(972) 522-0660
Fax
(972) 522-0572
NPI assigned
Nov 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2009

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

Authorized official

Name
Yoon K Tak, DMDNPI 1548307077
Title
President
Phone
(972) 522-0660

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 23670 TX Primary

Addresses

Primary practice location

5115 Lakeridge Parkway
#200
Grand Prairie, TX 75052

Mailing address

5115 Lakeridge Parkway
#200
Grand Prairie, TX 75052
Phone (817) 368-9170

Other names 1

  • Grand prairieChildrens Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

5115 Lake Ridge Pkwy
Ste 200
Grand Prairie, TX 75052
Phone (972) 522-0660

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248220800000",
    "number": "1801040993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 LAKERIDGE PARKWAY",
            "address_2": "#200",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "75052",
            "telephone_number": "817-368-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 LAKERIDGE PARKWAY",
            "address_2": "#200",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "75052",
            "telephone_number": "972-522-0660",
            "fax_number": "972-522-0572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOON K TAK DMD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-17",
        "last_updated": "2009-07-22",
        "status": "A",
        "authorized_official_last_name": "TAK",
        "authorized_official_first_name": "YOON",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-522-0660",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "23670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand prairieChildrens Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; 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.