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General NPI Number Information
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NPI Number | 1962799502
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Entity Type | Individual
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Provider Name | TARYN MARIE POGODA D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/04/2011
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Last Update Date | 01/11/2021
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Provider Practice Location Address
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Address Line | 6760 ABRAMS RD STE 201
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City | DALLAS
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State | TX
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Zip | 75231-0245
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Country | US
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Telephone | 214-349-9455
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Fax |
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Provider Business Mailing Address
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Address Line | 6760 ABRAMS RD STE 201
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City | DALLAS
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State | TX
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Zip | 75231-0245
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Country | US
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Telephone | 908-705-4971
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI02474800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 31759
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License Number State | TX
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