| Ikids Pediatric Dentistry Viridian, PLLC | |
|
4100 N. Collins St. Bldg. 7, Ste. 100 Arlington TX 76011 | |
| (682) 222-1010 | |
| Not Available |
| Full Name | Ikids Pediatric Dentistry Viridian, PLLC |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 4100 N. Collins St., Arlington, Texas |
| Authorized Official Name and Position | Alyssa Aguilar (DIRECTOR OF REVENUE & CREDENTIALING) |
| Authorized Official Contact | 8174668554 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ikids Pediatric Dentistry Viridian, PLLC 2500 E Broad St Ste 204 Mansfield TX 76063-4361 Ph: (817) 466-8554 | Ikids Pediatric Dentistry Viridian, PLLC 4100 N. Collins St. Bldg. 7, Ste. 100 Arlington TX 76011 Ph: (682) 222-1010 |
| NPI Number | 1992213987 |
|---|---|
| Provider Enumeration Date | 01/12/2018 |
| Last Update Date | 03/04/2021 |
| Certification Date | 03/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992213987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | () | Primary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | () | Secondary |
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