Provider Demographics
NPI:1235750852
Name:JSK DENTAL PLLC
Entity Type:Organization
Organization Name:JSK DENTAL PLLC
Other - Org Name:ACE FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HIREN
Authorized Official - Middle Name:
Authorized Official - Last Name:KORAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-260-7476
Mailing Address - Street 1:4418 ARCHER MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-6877
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3733 HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5249
Practice Address - Country:US
Practice Address - Phone:848-260-7476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-05
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty