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General NPI Number Information
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NPI Number | 1427859958
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Entity Type | Organization
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Legal Business Name | NEXTGEN SMILES LLC
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Dates
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Enumeration Date | 03/21/2025
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 8409 W CLEBURNE RD
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City | FORT WORTH
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State | TX
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Zip | 76123-1421
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Country | US
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Telephone | 817-292-5927
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Fax |
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Provider Business Mailing Address
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Address Line | 721 LIMESTONE DR
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City | PROSPER
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State | TX
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Zip | 75078-8405
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Country | US
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Telephone | 940-595-4584
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NEERAV JAYASWAL
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Credential | DMD
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Telephone | 940-595-4584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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