MEDICARE: DENSU, INC

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	17244	TX

General Provider Information

NPI Number	:	1912008400
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENSU, INC

Provider Business Mailing Address
First Line	:	5045 FOREST BEND RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75244-6514
Country	:	US
Telephone Number	:	214-718-2336
Fax Number	:

Provider Business Practice Location Address
First Line	:	5045 FOREST BEND RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75244-6514
Country	:	US
Telephone Number	:	214-718-2336
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATIVE ASSISTANT
Name	:	JAZMIN NARVAEZ
Credential	:
Telephone Number	:	469-363-5457

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	08/22/2020

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