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CLINIQUE DALLAS PLASTIC SURGERY PLLC
NPI 1689808941
Surgery - Plastic and Reconstructive Surgery in Dallas, TX

Active since May 14, 2009
7777 FOREST LN STE C212, DALLAS, TX 75230(972) 566-2010(855) 592-2934 Get Directions Write a Review

NPPES record last updated: September 23, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Clinique Dallas Plastic Surgery Pllc NPPES

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

CLINIQUE DALLAS PLASTIC SURGERY PLLC (NPI 1689808941) is a healthcare organization registered as a plastic and reconstructive surgery in Dallas, Texas and active in the NPI registry since May 2009. The organization lists John William Antonetti, Ceo/surgeon, as its authorized official.

NPPES Registry Identity

NPI1689808941
Entity TypeOrganization
Primary Taxonomy2086S0122X
Legal Business NameCLINIQUE DALLAS PLASTIC SURGERY PLLC
Location Address7777 FOREST LN STE C212Dallas, TX 75230-6836
Mailing Address7777 Forest Ln Ste C212Dallas, TX 75230-6836 · (972) 566-2010 · Fax (855) 592-2934
Phone(972) 566-2010
Fax(855) 592-2934
Organization SubpartNo
Authorized OfficialJohn William AntonettiCeo/surgeon · (972) 566-2010
Enumeration DateMay 14, 2009
Last NPPES UpdateSeptember 23, 2025
NPPES CertifiedSeptember 23, 2025
✔ NPI 1689808941 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
Definition
A surgeon who specializes in plastic and reconstructive surgery.
Also ListedPlastic SurgeryTaxonomy 208200000X
7777 FOREST LN STE C212, Dallas, TX 75230
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Other Identifiers 1

Medicaid2931776-01TX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Clinique Dallas Plastic Surgery Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Clinique Dallas Plastic Surgery PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

John Antonetti, M.D.
Plastic and Reconstructive Surgery
NPI 1992916266
7777 FOREST LN STE C212
Dallas, TX 75230
(214) 708-6961
✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Clinique Dallas Plastic Surgery PLLC's NPI number?

The NPI number for Clinique Dallas Plastic Surgery PLLC is 1689808941. It was assigned to this organization in the NPPES registry on May 14, 2009.

Where is Clinique Dallas Plastic Surgery PLLC located?

Clinique Dallas Plastic Surgery PLLC is located at 7777 Forest Ln Ste C212, Dallas, TX 75230. The listed phone number is (972) 566-2010.

What is Clinique Dallas Plastic Surgery PLLC's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Is Clinique Dallas Plastic Surgery PLLC enrolled in Medicare?

Yes. Clinique Dallas Plastic Surgery PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Clinique Dallas Plastic Surgery PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Plastic and Reconstructive Surgery) reassigns their Medicare billing to Clinique Dallas Plastic Surgery PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Clinique Dallas Plastic Surgery PLLC was last updated on September 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.