Village Dds Pllc

LBN: Village Dds Pllc
Village Dds Pllc is an health care organization with primary practice located at 4041 W Wheatland Rd Suite 202, Dallas TX 75237-4063. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Orthodontics and Dentofacial Orthopedics. Dental Providers / Orthodontics and Dentofacial Orthopedics is the primary health care specialty. Village Dds Pllc can be contacted via phone (817) 306-1738, or through Fetouh, Omar via phone (716) 348-9855.

Contact Information

Primary practice address
4041 W Wheatland Rd Suite 202 Dallas TX 75237-4063
Phone: (817) 306-1738
Fax: (817) 306-7366
Website:
Map and Directions
Authorized official contact:
Name: Fetouh, Omar
Phone: (716) 348-9855

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 30316 Texas
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 24314 Texas

Profile Details

NPI number 1396101010
LBN Legal business name Village Dds Pllc
DBA Doing business as
Authorized official Fetouh, Omar
Entity Organization
Organization subpart 1 No
Enumeration date Jan 11th, 2016
Last updated Jan 11th, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396101010 NPPES
Texas MEDICAID 1568871523
Texas MEDICAID 1992950042

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