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NPI · 1154544740 · NPPES-sourced

Southlake Dental Corp

ActivePeriodontics
NPI Number
1154544740
Type 2 · Organisation
Taxonomy Code
1223P0300X
Contact
(817) 336-1166
License TX · 9930
Last Updated
Enumerated
Primary practice addressTX · 76104
1124 S Lake Street, Suite BFort Worth, TX 76104
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About this NPIWhat this record shows.

NPI 1154544740 is registered to Southlake Dental Corp, a healthcare organisation classified as "Periodontics" and located at 1124 S Lake Street, Suite B in Fort Worth, Texas. The organisation's authorised official is Dwain Matelski. The organisation has been enumerated in the NPI registry since 2007.

Provider type
Organisation (Type 2)
Status
Active
Enumerated
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Insurance & acceptsHow to confirm coverage.

The National Plan and Provider Enumeration System (NPPES) registry does not include commercial insurance network data, so we cannot show which plans Southlake Dental Corp accepts. To confirm in-network status with your specific health plan, contact Southlake Dental Corp directly at (817) 336-1166.

Frequently asked

Yes. NPI 1154544740 is registered as Active in the CMS NPPES public registry and passes the Luhn check-digit validation that all 10-digit NPIs use.

Periodontics is a recognised medical specialty under the National Uniform Claim Committee (NUCC) taxonomy.

The CMS NPPES Public Registry at npiregistry.cms.hhs.gov is the authoritative source. FindMyNPI mirrors this dataset and refreshes monthly. For real-time verification, you can also call the provider's office at (817) 336-1166.

An individual healthcare provider has a single Type-1 NPI for life. Organisations can hold separate Type-2 NPIs per location, specialty, or sub-entity. Southlake Dental Corp is a Type-2 organisational NPI.

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Quick facts

Provider typeOrganisation
Taxonomy1223P0300X
Last updated
Enumerated
StatusActive
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partner offer
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