MEDICARE: VIRK TMJ 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	1223X2210X	Orofacial Pain Dentistry

General Provider Information

NPI Number	:	1922992015
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRK TMJ PLLC

Provider Business Mailing Address
First Line	:	1160 N KIMBALL AVE STE 110
Second Line	:
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-5572
Country	:	US
Telephone Number	:	817-251-9985
Fax Number	:

Provider Business Practice Location Address
First Line	:	3116 CAPITAL WAY STE 100
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-4305
Country	:	US
Telephone Number	:	817-251-9985
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	AMRITTEJ SINGH VIRK
Credential	:	DMD
Telephone Number	:	623-980-2315

Provider Enumeration Date	:	06/04/2025
Last Update Date	:	06/04/2025

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