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NPI Code Detail

MEDICARE: MONI DENTISTRY PLLC

MEDICARE: MONI DENTISTRY 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
1125K00000XAdvanced Practice Dental Therapist
2125Q00000XOral Medicine Dentistry
3207K00000XAllergy & Immunology Physician
4207P00000XEmergency Medicine Physician
5207Q00000XFamily Medicine Physician
6207ZF0201XForensic Pathology Physician
7207ZP0102XAnatomic Pathology & Clinical Pathology Physician
82085R0202XDiagnostic Radiology Physician
92085R0205XRadiological Physics Physician
10208D00000XGeneral Practice Physician
11208U00000XClinical Pharmacology Physician
12122300000XDentist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11124495189OTHERTXNPI TYPE 1

General Provider Information

NPI Number : 1790297778
Entity Type Code : Organization
Provider Name (Legal Business Name) : MONI DENTISTRY PLLC
Provider Business Mailing Address
First Line : 820 N ZANG BLVD STE 110
Second Line :
City : DALLAS
State : TX
Zip : 75208-4233
Country : US
Telephone Number : 214-948-3364
Fax Number :
Provider Business Practice Location Address
First Line : 820 N ZANG BLVD STE 110
Second Line :
City : DALLAS
State : TX
Zip : 75208-4233
Country : US
Telephone Number : 214-948-3364
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. MONIZA MUNAWAR
Credential : DDS
Telephone Number : 214-948-3364
Provider Enumeration Date : 10/30/2017
Last Update Date : 01/31/2020

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Directions to “MONI DENTISTRY PLLC ” Practice Location

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