| Ikids Pediatric Dentistry Arlington | |
|
3801 S Cooper St Ste 109 Arlington TX 76015 | |
| (817) 467-9089 | |
| (817) 472-9008 |
| Full Name | Ikids Pediatric Dentistry Arlington |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 3801 S Cooper St Ste 109, 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 Arlington 2500 E Broad St Ste 204 Mansfield TX 76063-4361 Ph: (817) 466-8554 | Ikids Pediatric Dentistry Arlington 3801 S Cooper St Ste 109 Arlington TX 76015 Ph: (817) 467-9089 |
| NPI Number | 1700168192 |
|---|---|
| Provider Enumeration Date | 09/13/2011 |
| Last Update Date | 03/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700168192 | NPI | - | NPPES |
| 200886401 | Medicaid | TX | |
| 200886404 | Medicaid | TX | |
| 200886402 | Medicaid | TX | |
| 200886403 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 24272 (Texas) | Primary |
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