Provider Demographics
NPI:1295248615
Name:MEDLEX DENTAL GROUP P.C.
Entity type:Organization
Organization Name:MEDLEX DENTAL GROUP P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.D.S./OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAM-SARWAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-775-9524
Mailing Address - Street 1:5321 E MOCKINGBIRD LN STE 210
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-0915
Mailing Address - Country:US
Mailing Address - Phone:214-824-7873
Mailing Address - Fax:
Practice Address - Street 1:5321 E MOCKINGBIRD LN STE 210
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-0915
Practice Address - Country:US
Practice Address - Phone:214-824-7873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty