Provider Demographics
NPI:1558736595
Name:SMILEZ DENTAL OF MCKINNEY
Entity Type:Organization
Organization Name:SMILEZ DENTAL OF MCKINNEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:NIDHI
Authorized Official - Middle Name:
Authorized Official - Last Name:JAISWAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:940-230-0219
Mailing Address - Street 1:4150 ELDORADO PKWY
Mailing Address - Street 2:SUITE#300
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-5399
Mailing Address - Country:US
Mailing Address - Phone:214-504-0500
Mailing Address - Fax:
Practice Address - Street 1:4150 ELDORADO PKWY
Practice Address - Street 2:SUITE#300
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-5399
Practice Address - Country:US
Practice Address - Phone:214-504-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty