Healthcare Provider Details

I. General information

NPI: 1629503123
Provider Name (Legal Business Name): KREATING PERFECT SMILES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2017
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2932 N BELT LINE RD
IRVING TX
75062-5247
US

IV. Provider business mailing address

1924 ANGEIN LN
FORT WORTH TX
76131-1059
US

V. Phone/Fax

Practice location:
  • Phone: 201-920-1917
  • Fax:
Mailing address:
  • Phone: 201-920-2457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. RUSHABH DOSHI
Title or Position: MANAGING MEMBER
Credential: DMD
Phone: 201-920-1917