Healthcare Provider Details

I. General information

NPI: 1881172450
Provider Name (Legal Business Name): LAUREN FLYNN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2018
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5285 DALLAS PKWY STE 500
FRISCO TX
75034-9634
US

IV. Provider business mailing address

5285 DALLAS PKWY STE 500
FRISCO TX
75034-9634
US

V. Phone/Fax

Practice location:
  • Phone: 817-576-1577
  • Fax:
Mailing address:
  • Phone: 817-576-1577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number33063
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number33063
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: