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CUSTOM DENTAL OF CARROLLTON, PLLC
NPI 1366924383
Clinic/Center - Dental in Dallas, TX

Active since September 06, 2018
17610 MIDWAY RD STE 110, DALLAS, TX 75287(405) 227-6100 Get Directions Write a Review

NPPES record last updated: September 8, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 8, 2021, Sep 6, 2018 (2 updates tracked since 2018).

About Custom Dental Of Carrollton, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CUSTOM DENTAL OF CARROLLTON, PLLC (NPI 1366924383) is a healthcare organization registered as a dental in Dallas, Texas and active in the NPI registry since September 2018. The organization lists Rene Rodgers, Coo, as its authorized official.

NPPES Registry Identity

NPI1366924383
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameCUSTOM DENTAL OF CARROLLTON, PLLC
Location Address17610 MIDWAY RD STE 110Dallas, TX 75287-6741
Mailing Address17610 Midway Rd Ste 110Dallas, TX 75287-6741 · (405) 227-6100
Phone(405) 227-6100
Organization SubpartNo
Authorized OfficialRene RodgersCoo · (405) 227-6100
Enumeration DateSeptember 6, 2018
Last NPPES UpdateSeptember 8, 20212 updates tracked since enumeration
NPPES CertifiedSeptember 8, 2021
✔ NPI 1366924383 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
License✔ Licensed in TX · 26171
17610 MIDWAY RD STE 110, Dallas, TX 75287
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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KA PARK DMD PLLC
Dentist
17610 MIDWAY RD STE 110
DALLAS, TX 75287
Collin County (972) 735-8900
ELEGANT SMILES
Dentist
17610 MIDWAY RD STE 110
DALLAS, TX 75287
Collin County (972) 735-8900

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Custom Dental Of Carrollton, PLLC's NPI number?

The NPI number for Custom Dental Of Carrollton, PLLC is 1366924383. It was assigned to this organization in the NPPES registry on September 6, 2018.

Where is Custom Dental Of Carrollton, PLLC located?

Custom Dental Of Carrollton, PLLC is located at 17610 Midway Rd Ste 110, Dallas, TX 75287. The listed phone number is (405) 227-6100.

What is Custom Dental Of Carrollton, PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Custom Dental Of Carrollton, PLLC was last updated on September 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.