MEDICARE: AFFORDABLE DENTIST NEAR ME EAST DALLAS 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	:	1689515975
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFORDABLE DENTIST NEAR ME EAST DALLAS PLLC

Provider Business Mailing Address
First Line	:	3535 N BUCKNER BLVD STE 114
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-5633
Country	:	US
Telephone Number	:	817-656-1215
Fax Number	:	877-230-8349

Provider Business Practice Location Address
First Line	:	3535 N BUCKNER BLVD STE 114
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-5633
Country	:	US
Telephone Number	:	817-656-1215
Fax Number	:	877-230-8349

Authorized Official
Title or Position	:	MANAGER
Name	:	SARAH SAQIB
Credential	:	STAFF
Telephone Number	:	817-656-1215

Provider Enumeration Date	:	04/02/2026
Last Update Date	:	04/02/2026

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