Provider Demographics
NPI:1932658481
Name:SKM DENTISTRY PLLC
Entity Type:Organization
Organization Name:SKM DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:KHALID
Authorized Official - Last Name:MAHMOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-534-1915
Mailing Address - Street 1:800 FOREST OAKS LN STE A
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053-4959
Mailing Address - Country:US
Mailing Address - Phone:214-534-1915
Mailing Address - Fax:
Practice Address - Street 1:800 FOREST OAKS LN STE A
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76053-4959
Practice Address - Country:US
Practice Address - Phone:817-770-0272
Practice Address - Fax:817-770-0271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-26
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX310291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty