| Dental Innovation Of Plano | |
|
5940 W Parker Rd Ste 103 Plano TX 75093-6404 | |
| (214) 619-6329 | |
| Not Available |
| Full Name | Dental Innovation Of Plano |
|---|---|
| Speciality | Clinic/Center |
| Location | 5940 W Parker Rd Ste 103, Plano, Texas |
| Authorized Official Name and Position | Omar Yousuf (OWNER) |
| Authorized Official Contact | 5042373558 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Innovation Of Plano 2012 Southlake Glen Dr Southlake TX 76092-1422 Ph: (504) 237-3558 | Dental Innovation Of Plano 5940 W Parker Rd Ste 103 Plano TX 75093-6404 Ph: (214) 619-6329 |
| NPI Number | 1790352920 |
|---|---|
| Provider Enumeration Date | 06/07/2021 |
| Last Update Date | 01/07/2025 |
| Medicare PECOS PAC ID | 9739617028 |
|---|---|
| Medicare Enrollment ID | O20250114003970 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790352920 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Omar Mohammed Yousuf |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1023371945 PECOS PAC ID: 0648708933 Enrollment ID: I20250114003993 |
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