Provider Demographics
NPI:1043740004
Name:JOSEPH, VARUN (DDS)
Entity Type:Individual
Prefix:
First Name:VARUN
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3405 SILVERSTONE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-7875
Mailing Address - Country:US
Mailing Address - Phone:972-867-5090
Mailing Address - Fax:
Practice Address - Street 1:3405 SILVERSTONE DR STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023
Practice Address - Country:US
Practice Address - Phone:972-867-5090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2019-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX329781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice