Southwestern Perio & Implant, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

29604 Issued in TX

Legal business name

SOUTHWESTERN PERIO & IMPLANT, PLLC

Practice address

697 E State Highway 121 Ste 100
Coppell, TX 75019-7950

Phone

(972) 315-2345

NPI assigned

May 9, 2016

Organization subpart

No

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

Authorized official

Name

Jaebum Lee, DDS

Title

Owner

Phone

(972) 315-2345

Specialties & licenses 1

Addresses

Other names 1

• Edelweiss Dental Implant Center Doing business as

Locations

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462752000000",
    "number": "1801242995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "697 E STATE HIGHWAY 121 STE 100",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750197950",
            "telephone_number": "972-315-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "697 E STATE HIGHWAY 121 STE 100",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750197950",
            "telephone_number": "972-315-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWESTERN PERIO & IMPLANT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-09",
        "last_updated": "2016-05-09",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JAEBUM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-315-2345",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TX",
            "license": "29604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edelweiss Dental Implant Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Peyton Smith, PT, DPT
• Brittany Sokoloski
• Arthur C Solomon, R.PH.
• Sonia Louca, DDS, PLLC
• Annie Soren
• Paige Spangler, PT
• Sparks Healthcare Services Inc
• Spooner Physical Therapy & Hand Rehab, PC
• Lori B Spors
• Meagan Taylor Springer, DPT

• Dental Clinic/Center in Coppell, TX
• Providers in Coppell, 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 May 9, 2016; 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.