Provider Demographics
NPI:1356669725
Name:STARLITE ORTHODONTICS
Entity type:Organization
Organization Name:STARLITE ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HOANH
Authorized Official - Middle Name:T
Authorized Official - Last Name:BUI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:972-709-4300
Mailing Address - Street 1:3215 KIRNWOOD DR
Mailing Address - Street 2:SUITE #102
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-4432
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3215 KIRNWOOD DR
Practice Address - Street 2:SUITE #102
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-4432
Practice Address - Country:US
Practice Address - Phone:972-709-4300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-11
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX248161223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty