MEDICARE: OROFACIAL PAIN & SLEEP CENTER, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QD0000X	Dental Clinic/Center
2	261QP3300X	Pain Clinic/Center
3	332B00000X	Durable Medical Equipment & Medical Supplies
4	1223X2210X	Orofacial Pain Dentistry

General Provider Information

NPI Number	:	1588489876
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OROFACIAL PAIN & SLEEP CENTER, PLLC

Provider Business Mailing Address
First Line	:	3604 PRESTON RD STE 500
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-8631
Country	:	US
Telephone Number	:	972-758-2200
Fax Number	:	972-758-2202

Provider Business Practice Location Address
First Line	:	3604 PRESTON RD STE 500
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-8631
Country	:	US
Telephone Number	:	972-758-2200
Fax Number	:	972-758-2202

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	VEENA KANTI
Credential	:	DDS, MDS
Telephone Number	:	480-347-6525

Provider Enumeration Date	:	11/20/2024
Last Update Date	:	11/20/2024

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