Provider Demographics
NPI:1710651062
Name:VARGHESE, ALLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:
Last Name:VARGHESE
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 1:5933 DALLAS PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8521
Mailing Address - Country:US
Mailing Address - Phone:972-781-1880
Mailing Address - Fax:
Practice Address - Street 1:5933 DALLAS PKWY STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8521
Practice Address - Country:US
Practice Address - Phone:972-781-1880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37713122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist