Provider Demographics
NPI:1801345087
Name:LUXSMILE PLLC
Entity type:Organization
Organization Name:LUXSMILE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:THANH
Authorized Official - Last Name:TON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-516-4460
Mailing Address - Street 1:3320 E HEBRON PKWY
Mailing Address - Street 2:STE 112
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4474
Mailing Address - Country:US
Mailing Address - Phone:214-516-4460
Mailing Address - Fax:
Practice Address - Street 1:3320 E HEBRON PKWY
Practice Address - Street 2:STE 112
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4474
Practice Address - Country:US
Practice Address - Phone:214-516-4460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21448122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty