NPIMap

Organization Active NPI

Plano Dental Imaging, PLLC

  • Dentist
  • Plano, TX
National Provider Identifier
1942550686
Registry record updated Sep 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
17551 Issued in TX
Legal business name
PLANO DENTAL IMAGING, PLLC
Practice address
5509 Pleasant Valley Dr
Suite 700
Plano, TX 75023
Phone
(972) 612-7100
Fax
(972) 499-2420
NPI assigned
Sep 10, 2012
Last updated
Sep 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2012

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

Authorized official

Name
Dr. William M Bolak, DMDNPI 1255412979
Title
Manager
Phone
(972) 612-7100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 17551 TX Primary
Oral and Maxillofacial Radiology DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223X0008X 17551 TX

Addresses

Primary practice location

5509 Pleasant Valley Dr
Suite 700
Plano, TX 75023

Mailing address

910 Presidio CT
Allen, TX 75013
Phone (972) 612-7100

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347235200000",
    "number": "1942550686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 PRESIDIO CT",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "75013",
            "telephone_number": "972-612-7100",
            "fax_number": "972-499-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5509 PLEASANT VALLEY DR",
            "address_2": "SUITE 700",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75023",
            "telephone_number": "972-612-7100",
            "fax_number": "972-499-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLANO DENTAL IMAGING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-10",
        "last_updated": "2012-09-10",
        "status": "A",
        "authorized_official_last_name": "BOLAK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "972-612-7100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "17551",
            "primary": true
        },
        {
            "code": "1223X0008X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "TX",
            "license": "17551",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; 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.