Provider Demographics
NPI:1780122556
Name:ENDODONTIC ASSOCIATES OF PLANO, PLLC
Entity type:Organization
Organization Name:ENDODONTIC ASSOCIATES OF PLANO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOGESH
Authorized Official - Middle Name:T
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-342-0425
Mailing Address - Street 1:1026 E WHEATLAND RD
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4914
Mailing Address - Country:US
Mailing Address - Phone:469-206-2522
Mailing Address - Fax:
Practice Address - Street 1:5072 W PLANO PKWY
Practice Address - Street 2:270
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4476
Practice Address - Country:US
Practice Address - Phone:214-342-0425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201231223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty