MEDICARE: MY DENISON DENTAL PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1235063769
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MY DENISON DENTAL PLLC

Provider Business Mailing Address
First Line	:	3515 W FM 120 STE 109
Second Line	:
City	:	DENISON
State	:	TX
Zip	:	75020-1556
Country	:	US
Telephone Number	:	361-446-6396
Fax Number	:

Provider Business Practice Location Address
First Line	:	3515 W FM 120 STE 109
Second Line	:
City	:	DENISON
State	:	TX
Zip	:	75020-1556
Country	:	US
Telephone Number	:	361-446-6396
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	RAGHAV PURI
Credential	:	BDS, MS
Telephone Number	:	361-446-6396

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/10/2026

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Directions to “MY DENISON DENTAL PLLC ” Practice Location

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