Highland Dental Laboratory, LLC

Primary specialty

Dental LaboratoryTaxonomy code 292200000X

License

0003065 Issued in TX

Legal business name

HIGHLAND DENTAL LABORATORY, LLC

Practice address

4054 McKinney Ave Ste 103
Dallas, TX 75204-2050

Phone

(214) 559-2292

Fax

(214) 559-2697

NPI assigned

Jun 18, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Anthony O Semprun

Title

Operations Manager

Phone

(214) 559-2292

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1942461405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4054 MCKINNEY AVE STE 103",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752042050",
            "telephone_number": "214-559-2292",
            "fax_number": "214-559-2697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4054 MCKINNEY AVE STE 103",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752042050",
            "telephone_number": "214-559-2292",
            "fax_number": "214-559-2697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND DENTAL LABORATORY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-18",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "SEMPRUN",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "214-559-2292",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "292200000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory",
            "state": "TX",
            "license": "0003065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF DENTAL EXAMINERS",
            "identifier": "0003065",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dental Laboratory in Dallas, TX
• Providers in Dallas, TX by specialty
• Dental Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.