Provider Demographics
NPI:1598853459
Name:SINN, DAX MICHAEL (DDS)
Entity Type:Individual
Prefix:
First Name:DAX
Middle Name:MICHAEL
Last Name:SINN
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 1:841 N TARRANT PKWY
Mailing Address - Street 2:#112
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-3400
Mailing Address - Country:US
Mailing Address - Phone:817-605-8200
Mailing Address - Fax:817-605-8282
Practice Address - Street 1:841 N TARRANT PKWY
Practice Address - Street 2:#112
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-3400
Practice Address - Country:US
Practice Address - Phone:817-605-8200
Practice Address - Fax:817-605-8282
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210751223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice