Organization · Type 2 NPI

TX Southern Dental Ppo PC

General Practice Dentistry · The Colony, TX

NPI number 1689355976 Active

Practice location

5204 S Colony Blvd Ste 150
The Colony, TX 75056-2390

Call (469) 656-7265 Map

Mailing address

5830 Granite Pkwy Ste 780
Plano, TX 75024-6775

Specialties and licenses

Taxonomy	Code	License
General Practice Dentistry Primary	1223G0001X	None listed

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

2 other providers at this address

Other general practice dentistry providers in The Colony

See all in The Colony →

NPI record

NPI: 1689355976
Entity type: Organization (Type 2)
Issued: Jul 28, 2023
Last updated: Mar 17, 2026
Status: Active
Subpart: Yes of TX Southern Dental Ppo PC

Other names

The Colony Family Dental · doing business as

Authorized official

Erika Melissa Menjivar
Sr. Credentialing Specialist
(469) 596-6137

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1689355976

TX Southern Dental Ppo PC's National Provider Identifier is 1689355976, issued on Jul 28, 2023. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in The Colony, TX. The record was last updated on Mar 17, 2026.