CRE8TIVE PEDIATRIC DENTAL GROUP

Address: 2201 Fort Worth Avenue, Dallas, TX 75211
Phone: 9725447524

CRE8TIVE PEDIATRIC DENTAL GROUP (NPI# 1447883863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1447883863
Entity Type Organization
Organization Name CRE8TIVE PEDIATRIC DENTAL GROUP
Practice Address 2201 Fort Worth Avenue
Dallas
TX 75211
Mailing Address 2787 N Houston St Apt 4002
Dallas
TX 75219-5042
Practice Telephone 9725447524
Mailing Telephone 2819358668
Enumeration Date 2020-02-13
Last Update Date 2020-02-13
Authorized Official Name DR. JESSICA MARSHALL (PEDIATRIC DENTIST/OWNER)
Authorized Official Telephone 9725447524
Authorized Official Credential DDS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223P0221X Dentist
Specialization: Pediatric Dentistry
Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
TX 1841425394 05

Office Location

Street Address 2201 FORT WORTH AVENUE
City DALLAS
State TX
Zip Code 75211

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1104317601 May Amria Dentist 3434 W Illinois Ave Ste 307, Dallas, TX 75211 2018-05-21
1235547787 Los Barrios Unidos Community Clinic, Inc Clinic/Center 4732 W. Illinois, Dallas, TX 75211 2014-07-29
1568733616 Amit Sethi Dentist 4475 Adler Dr Ste 103, Dallas, TX 75211 2012-01-21
1265764914 Thomas Lee Schiller Dentist 1441 N. Cockrell Hill Rd.., Dallas, TX 75211 2010-02-05
1407030570 Sylvia Dupuy Speech-Language Pathologist 1353 N. Westmoreland Rd., Bldg F, Dallas, TX 75211 2007-12-24
1801088802 Smile Care Orthodontics Dentist 4390 I-30, Ste 200, Dallas, TX 75211 2007-08-14
1104047364 Ronald Leon Thomas Pharmacist 1350 N. Westmoreland, Pharmacy Service, Dallas, TX 75211 2007-05-02
1578785515 Rabiu E Omolaja Case Manager/Care Coordinator 1353 N. Westmoreland Road #2, Dallas, TX 75211 2007-05-02
1982828687 Yokitha Kenyetta Hamp Counselor 1253 Westmoreland, Dallas, TX 75211 2007-04-12
1285858399 Cyril Odiachi Counselor 1353 N Westmoreland, Building A, Dallas, TX 75211 2007-04-12
Find all providers in zip 75211

Taxonomy Information

Taxonomy Code 1223P0221X
Grouping Dental Providers
Classification Dentist
Specialization Pediatric Dentistry

Taxonomy Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1316564990 Ikids Pediatric Dentistry Lakewood, Pllc Dentist 2011 Abrams Parkway, Dallas, TX 75214 2020-06-30
1851944706 Buckner Rsvglc Pllc Dentist 2702 S Buckner Blvd # 111, Dallas, TX 75227-6903 2019-07-19
1881170355 Awesome Kids Dentistry Dentist 3217 W Davis St, Dallas, TX 75211-2923 2018-07-17
1053812081 Armin Afshar Dentist 201 Se Washington St Ste A, Dallas, OR 97338-2860 2018-02-25
1477077717 Children'S Dental At Preston Trail, PC Dentist 17194 Preson Road, Dallas, TX 75248 2017-07-28
1558897686 Chandler Choate Borth Dentist 8305 Walnut Hill Ln Ste 225, Dallas, TX 75231-4259 2017-05-10
1629516919 William Preston Colven Jr. Dentist 8355 Walnut Hill Ln Ste 125, Dallas, TX 75231-4237 2017-02-07
1447797188 A Smile for Life Pllc Dentist 324 Medallion Ctr, Dallas, TX 75214-1580 2017-01-19
1740649441 J Diane Colter, Dds, Pa Dentist 12300 Inwood Rd., Ste #220, Dallas, TX 75244 2016-02-23
1568820009 Ashley Nicole Green Dentist 2221 W. Ledbetter Drive, Suite 100, Dallas, TX 75224 2016-01-28
Find all providers in DALLAS

Competitor

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City DALLAS
Zip Code 75211

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.