| Radiance Dentistry | |
|
1235 Kinwest Pkwy Irving TX 75063-3403 | |
| (972) 258-1702 | |
| (972) 258-1703 |
| Full Name | Radiance Dentistry |
|---|---|
| Speciality | Dentist - Prosthodontics |
| Location | 1235 Kinwest Pkwy, Irving, Texas |
| Authorized Official Name and Position | Mounir Iskandar (DENTIST) |
| Authorized Official Contact | 9722581702 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Radiance Dentistry 1235 Kinwest Pkwy Irving TX 75063-3403 Ph: (972) 258-1702 | Radiance Dentistry 1235 Kinwest Pkwy Irving TX 75063-3403 Ph: (972) 258-1702 |
| NPI Number | 1902105711 |
|---|---|
| Provider Enumeration Date | 03/18/2011 |
| Last Update Date | 11/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902105711 | NPI | - | NPPES |
| 27805703 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 23921 (Texas) | Secondary |
| 1223P0700X | Dentist - Prosthodontics | (* (Not Available)) | Primary |
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