Provider Demographics
NPI:1689044612
Name:TRANQUILITY DENTAL, PLLC
Entity Type:Organization
Organization Name:TRANQUILITY DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-315-2345
Mailing Address - Street 1:697 E STATE HIGHWAY 121
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-7951
Mailing Address - Country:US
Mailing Address - Phone:972-315-2345
Mailing Address - Fax:972-315-0307
Practice Address - Street 1:697 E STATE HIGHWAY 121
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-7951
Practice Address - Country:US
Practice Address - Phone:972-315-2345
Practice Address - Fax:972-315-0307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-02
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21944122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty