Professional Dental Alliance of Texas, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PROFESSIONAL DENTAL ALLIANCE OF TEXAS, PLLC

Practice address

7748 Denton Hwy
Watauga, TX 76148-2463

Phone

(817) 581-2100

NPI assigned

Nov 3, 2020

Organization subpart

No

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

Authorized official

Name

Lauren Howard

Title

Credentialing Specialist

Phone

(757) 576-5479

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Joseph A Bonola, DDS

  • Dentist
  • Southlake, TX
  • NPI 1033396726
  NPD (past)
• Sandra Hernandez, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Southlake, TX
  • NPI 1215199104
  NPD (past)

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604361600000",
    "number": "1992306328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 S MILL ST",
            "city": "NEW CASTLE",
            "state": "PA",
            "postal_code": "161013680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7748 DENTON HWY",
            "city": "WATAUGA",
            "state": "TX",
            "postal_code": "761482463",
            "telephone_number": "817-581-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2680 E State Highway 114",
            "address_purpose": "LOCATION",
            "city": "Southlake",
            "state": "TX",
            "postal_code": "760926667",
            "country_code": "US",
            "telephone_number": "817-251-2121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ALLIANCE OF TEXAS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-03",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "757-576-5479"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shweta G Pattanad, DMD
• Chau N Pham, DO
• Hai X Pham, DDS
• Melody Ann Pratt, LPC
• Prime Demtal Texas PLLC
• Leah Ramirez, PHARMD
• Rehab Recovery Perform Chiropractic PLLC
• Oriana Reid, MS, BCBA, LBA
• Debra Lynn Rogers, LPC
• Meredith C Roswell, PHARMD

• General Practice Dentistry in Watauga, TX
• Providers in Watauga, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.