Provider Demographics
NPI:1083486591
Name:JONATHAN P SCHAACK DDS PLLC
Entity Type:Organization
Organization Name:JONATHAN P SCHAACK DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:SCHAACK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-517-2125
Mailing Address - Street 1:5971 VIRGINIA PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5618
Mailing Address - Country:US
Mailing Address - Phone:214-517-2125
Mailing Address - Fax:
Practice Address - Street 1:5971 VIRGINIA PKWY STE 300
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5618
Practice Address - Country:US
Practice Address - Phone:972-984-7890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty