Healthcare Provider Details

I. General information

NPI: 1801510748
Provider Name (Legal Business Name): 1521 W UNIVERSITY RD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2022
Last Update Date: 06/02/2023
Certification Date: 06/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1521 W UNIVERSITY DR STE 120
MCKINNEY TX
75069-3207
US

IV. Provider business mailing address

2401 E RANDOL MILL RD STE 520
ARLINGTON TX
76011-6380
US

V. Phone/Fax

Practice location:
  • Phone: 817-904-5050
  • Fax:
Mailing address:
  • Phone: 817-809-4860
  • Fax: 682-626-1824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: GUNJAN DHIR
Title or Position: OWNER
Credential: DDS
Phone: 817-809-4860