=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881090462
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CENTER FOR SLEEP AND TMJ THERPY PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/10/2014
-----------------------------------------------------
Last Update Date | 05/18/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 915 W EXCHANGE PKWY STE 170
-----------------------------------------------------
City | ALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75013-7017
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-727-7900
-----------------------------------------------------
Fax | 972-727-7902
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 915 W EXCHANGE PKWY STE 170
-----------------------------------------------------
City | ALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75013-7017
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-727-7900
-----------------------------------------------------
Fax | 972-727-7902
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. NAMRITA SINGH
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 972-727-7900
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------