Provider Demographics
NPI:1952759631
Name:DC DENTAL ASSOCIATES OF IRVING
Entity Type:Organization
Organization Name:DC DENTAL ASSOCIATES OF IRVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:TAKASHI
Authorized Official - Last Name:CHOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-793-0735
Mailing Address - Street 1:2740 VALWOOD PKWY STE 144
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-3562
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1111 W AIRPORT FWY
Practice Address - Street 2:STE 201
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-6203
Practice Address - Country:US
Practice Address - Phone:972-793-0735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29352261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental