Healthcare Provider Details

I. General information

NPI: 1033093372
Provider Name (Legal Business Name): FATIMA CHAUDHRY BDS,DPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2025
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2947 S BUCKNER BLVD STE 100
DALLAS TX
75227-6953
US

IV. Provider business mailing address

527 RENAISSANCE LN
IRVING TX
75060-4270
US

V. Phone/Fax

Practice location:
  • Phone: 214-381-3800
  • Fax:
Mailing address:
  • Phone: 469-478-0203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number41842
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: