MEDICARE: CORNERSTONE FAMILY DENTAL PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1154013100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORNERSTONE FAMILY DENTAL PLLC

Provider Business Mailing Address
First Line	:	2109 COMMERCE ST # 200
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-4305
Country	:	US
Telephone Number	:	972-248-1221
Fax Number	:

Provider Business Practice Location Address
First Line	:	6520 N PRESIDENT GEORGE BUSH HWY # 200
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75044-3925
Country	:	US
Telephone Number	:	972-271-1302
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. WILLIAM R JENNINGS
Credential	:	DDS
Telephone Number	:	940-206-8956

Provider Enumeration Date	:	05/25/2023
Last Update Date	:	06/26/2026

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