Real Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

REAL DENTAL PLLC

Practice address

1215 W. Pioneer Pkwy
Suite 130
Grand Prairie, TX 75052

Phone

(925) 324-4152

NPI assigned

Dec 16, 2017

Organization subpart

No

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

Authorized official

Name

John Kuan, DDS

Title

Owner

Phone

(925) 324-4152

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1513382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513382400000",
    "number": "1902312796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 W. PIONEER PKWY",
            "address_2": "SUITE 130",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "75052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 W. PIONEER PKWY",
            "address_2": "SUITE 130",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "75052",
            "telephone_number": "925-324-4152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REAL DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-16",
        "last_updated": "2017-12-16",
        "status": "A",
        "authorized_official_last_name": "KUAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "925-324-4152",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Grand Prairie, TX
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2017; 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.