Provider Demographics
NPI:1619920188
Name:FRISCO DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:FRISCO DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NEERAV
Authorized Official - Middle Name:S
Authorized Official - Last Name:JAYASWAL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:972-335-2201
Mailing Address - Street 1:8715 LEBANON RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-8658
Mailing Address - Country:US
Mailing Address - Phone:972-335-2201
Mailing Address - Fax:972-335-7553
Practice Address - Street 1:8715 LEBANON RD
Practice Address - Street 2:SUITE 300
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-8658
Practice Address - Country:US
Practice Address - Phone:972-335-2201
Practice Address - Fax:972-335-7553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19056122300000X
TX239241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty