Provider Demographics
NPI:1144992819
Name:DENTAL DEPOT OF MCKINNEY PLLC
Entity type:Organization
Organization Name:DENTAL DEPOT OF MCKINNEY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER DENTAL DEPOT DFW
Authorized Official - Prefix:DR
Authorized Official - First Name:HIMESH
Authorized Official - Middle Name:I
Authorized Official - Last Name:KANA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-795-9205
Mailing Address - Street 1:1260 W ROUND GROVE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-8075
Mailing Address - Country:US
Mailing Address - Phone:972-779-0789
Mailing Address - Fax:972-332-0141
Practice Address - Street 1:5250 STACY RD.
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070
Practice Address - Country:US
Practice Address - Phone:972-779-0789
Practice Address - Fax:972-332-0141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-01
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty