Provider Demographics
NPI:1750410775
Name:PERRY, SVETLANA P (DDS)
Entity type:Individual
Prefix:
First Name:SVETLANA
Middle Name:P
Last Name:PERRY
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 1:6150 ELDORADO PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-5721
Mailing Address - Country:US
Mailing Address - Phone:972-540-7500
Mailing Address - Fax:972-369-0267
Practice Address - Street 1:6150 ELDORADO PKWY STE 150
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-5721
Practice Address - Country:US
Practice Address - Phone:317-570-5689
Practice Address - Fax:972-369-0267
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24736122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200825070Medicaid