MEDICARE: PARKVIEW DENTAL OF PROSPER, 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	:	1447192141
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARKVIEW DENTAL OF PROSPER, PLLC

Provider Business Mailing Address
First Line	:	2810 W 1ST ST STE 10
Second Line	:
City	:	PROSPER
State	:	TX
Zip	:	75078-8150
Country	:	US
Telephone Number	:	972-829-3345
Fax Number	:

Provider Business Practice Location Address
First Line	:	2810 W 1ST ST STE 10
Second Line	:
City	:	PROSPER
State	:	TX
Zip	:	75078-8150
Country	:	US
Telephone Number	:	972-829-3345
Fax Number	:

Authorized Official
Title or Position	:	OWNER / DENTIST
Name	:	DUSTIN MCCAMMON
Credential	:	DMD
Telephone Number	:	972-829-3345

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/14/2026

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