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General NPI Number Information
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NPI Number | 1942609516
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Entity Type | Organization
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Legal Business Name | ISMAIL DENTAL GROUP, PLLC
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Dates
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Enumeration Date | 08/19/2014
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Last Update Date | 08/27/2024
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Provider Practice Location Address
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Address Line | 6420 N MACARTHUR BLVD STE 120
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City | IRVING
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State | TX
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Zip | 75039-2838
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Country | US
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Telephone | 972-255-5570
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Fax |
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Provider Business Mailing Address
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Address Line | 406 SANDY LN
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City | ALLEN
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State | TX
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Zip | 75013-4785
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Country | US
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Telephone | 469-226-9941
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | HADIA ISMAIL
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Credential | DMD
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Telephone | 972-255-5570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 28166
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number | 24193
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License Number State | TX
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