Provider Demographics
NPI:1518248590
Name:DR BS CHILDRENS DENTISTRY PLLC
Entity type:Organization
Organization Name:DR BS CHILDRENS DENTISTRY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:BAGGALEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:702-496-6777
Mailing Address - Street 1:3296 COUNTY ROAD 2134
Mailing Address - Street 2:
Mailing Address - City:CADDO MILLS
Mailing Address - State:TX
Mailing Address - Zip Code:75135-6703
Mailing Address - Country:US
Mailing Address - Phone:702-496-6777
Mailing Address - Fax:
Practice Address - Street 1:3839 PARKER RD STE 104
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-7818
Practice Address - Country:US
Practice Address - Phone:469-946-9905
Practice Address - Fax:469-890-2134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-02
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS6-1071223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty