Provider Demographics
NPI:1902359136
Name:TARAPORE, ROXANNE (DDS)
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:
Last Name:TARAPORE
Suffix:
Gender:F
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:JDC HEALTHCARE, 3030 LBJ FREEWAY
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-2112
Mailing Address - Country:US
Mailing Address - Phone:972-663-5301
Mailing Address - Fax:972-663-5229
Practice Address - Street 1:JDC HEALTHCARE, 3030 LBJ FREEWAY
Practice Address - Street 2:SUITE 1400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-2112
Practice Address - Country:US
Practice Address - Phone:972-663-5301
Practice Address - Fax:972-663-5229
Is Sole Proprietor?:No
Enumeration Date:2016-07-23
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0308861223G0001X
TX335441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice