Dentist Providers In Southlake, Texas

Search Dentist NPI records in Southlake, TX

Search or browse through the NPI records of dentist registered healthcare providers with a business address in Southlake, TX. The listings include accepted insurance information, Medicare acceptance status, and PECOS enrollment data. The total number of NPI records is 81, of which 26 are registered as organizations and 55 as individuals. A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

68% Individuals

32% Organizations

19% Female

49% Male

68% Individual Providers (55)32% Medical Organizations (26)19% Female Providers (15)49% Male Providers (40)

Map of Providers

We have mapped the Dentist providers in Southlake, TX to visually represent the practice location of each individual or organization. Click on any of the the pins to see the provider details at that location.

List of Providers

Table of Dentist NPI Profiles in Southlake, TX
NPI	Name	Address	Insurance	Medicare	PECOS
1003157694	SOHN DENTAL, PC (Organization)	165 STONEBRIDGE LN SUITE 100 SOUTHLAKE, TX 76092 (817) 431-8887		Non-Participating Provider	NO
1003811100	TATE FAMILY DENTISTRY, PA JOHN MICHAEL TATE DDS PA (Organization)	3101 E STATE HIGHWAY 114 STE A SOUTHLAKE, TX 76092 (817) 481-6364		Non-Participating Provider	NO
1003915349	RICHARD GLENN THORPE (Individual)	1940 E HWY 114 SUITE #100 SOUTHLAKE, TX 76092 (817) 488-3000	Aetna CVS Health Ambetter from Arizona Complete Health Ambetter from Arkansas Health & Wellness Ambetter from Louisiana Healthcare Connections Ambetter from Superior HealthPlan Ambetter of Oklahoma Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO EMI Health Florida Combined Life Humana Paramount Paramount Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1033242946	DAVINCI DENTISTRY (Organization)	100 W SOUTHLAKE BLVD SUITE 146 SOUTHLAKE, TX 76092 (817) 251-9333	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Paramount Paramount Dental	Non-Participating Provider	NO
1033373113	KHALDOUN F AL-AJLOUNI (Individual)	100 W SOUTHLAKE BLVD STE 146 SOUTHLAKE, TX 76092 (817) 251-9333	Ambetter from Arizona Complete Health Ambetter from Arkansas Health & Wellness Ambetter from Louisiana Healthcare Connections Ambetter from Superior HealthPlan Ambetter of Oklahoma Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO Florida Combined Life Guardian Humana UnitedHealthcare	Non-Participating Provider	NO
1033396726	JOSEPH A BONOLA (Individual)	2680 EAST STATE HWY 114 SOUTHLAKE, TX 76092 (817) 251-2121	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Renaissance Dental	Non-Participating Provider	NO
1083095079	PAOLA ANDREA ARCILA (Individual)	200 E SOUTHLAKE BLVD SOUTHLAKE, TX 76092 (817) 481-7999	Aetna CVS Health Ambetter from Arizona Complete Health Ambetter from Arkansas Health & Wellness Ambetter from Louisiana Healthcare Connections Ambetter from Superior HealthPlan Ambetter of Oklahoma Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO EMI Health Guardian Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY	Non-Participating Provider	NO
1093947095	MICHEL FARES ABOU-OBEID (Individual)	754 N CARROLL AVE SOUTHLAKE, TX 76092 (817) 488-1150	Aetna CVS Health Ambetter from Arizona Complete Health Ambetter from Arkansas Health & Wellness Ambetter from Louisiana Healthcare Connections Ambetter from Superior HealthPlan Ambetter of Oklahoma Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO DentaQuest USA Insurance Company Inc. EMI Health Florida Combined Life Guardian Paramount Paramount Dental Renaissance Dental Solstice Healthplans of Texas Inc. TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1114358876	TOLLESON ORTHODONTICS PLLC (Organization)	1050 E STATE HIGHWAY 114 STE 120 SOUTHLAKE, TX 76092 (817) 416-2200		Non-Participating Provider	NO
1144341793	KRYSTYN MARIE DISHAW (Individual)	1007 ASHLAWN DR SOUTHLAKE, TX 76092 (214) 543-1620	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas DentaQuest USA Insurance Company Inc. EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental Solstice Healthplans of Texas Inc. TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1154043867	SMILE REHAB CENTERS (Organization)	245 W STATE HIGHWAY 114 STE 130 SOUTHLAKE, TX 76092 (737) 747-2221	Aetna CVS Health	Non-Participating Provider	NO
1154777316	CHAD R ALLEN (Individual)	190 S WHITE CHAPEL BLVD SOUTHLAKE, TX 76092 (817) 488-3636	Humana	Non-Participating Provider	NO
1164902177	CARTER HAYES (Individual)	2379 N CARROLL AVE SOUTHLAKE, TX 76092 (817) 488-7512	Renaissance Dental	Non-Participating Provider	NO
1215067632	CHRISTOPHER M. DAVIS (Individual)	1422 MAIN ST 226 SOUTHLAKE, TX 76092 (817) 481-7733	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana	Non-Participating Provider	NO
1215199104	SANDRA HERNANDEZ (Individual)	2680 EAST STATE HWY 114 SOUTHLAKE, TX 76092 (817) 251-2121	Aetna CVS Health Ambetter from Arizona Complete Health Ambetter from Arkansas Health & Wellness Ambetter from Louisiana Healthcare Connections Ambetter from Superior HealthPlan Ambetter of Oklahoma Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1225125263	STEVEN J FUQUA (Individual)	1422 MAIN ST SUITE 207 SOUTHLAKE, TX 76092 (817) 410-8765		Non-Participating Provider	NO
1245499375	JAMES H HOLT (Individual)	600 E SOUTHLAKE BLVD SUITE 100 SOUTHLAKE, TX 76092 (817) 488-2273	Aetna CVS Health Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Humana	Non-Participating Provider	NO
1245596279	HANIFE CANAN BAYRAKTAROGLU (Individual)	245 W STATE HIGHWAY 114 STE 130 SOUTHLAKE, TX 76092 (737) 747-2221	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO Guardian Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1245671742	IDEAL DENTAL OF SOUTHLAKE, PLLC (Organization)	2645 E SOUTHLAKE BLVD SUITE 150 SOUTHLAKE, TX 76092 (817) 734-9445	Aetna CVS Health Ambetter from Arizona Complete Health Ambetter from Arkansas Health & Wellness Ambetter from Louisiana Healthcare Connections Ambetter from Superior HealthPlan Ambetter of Oklahoma Solstice Healthplans of Texas Inc. UnitedHealthcare	Non-Participating Provider	NO
1285190777	SMILE BRITE DENTAL & ORTHODONTICS (Organization)	113 RIVER OAKS DR SOUTHLAKE, TX 76092 (817) 751-1777		Non-Participating Provider	NO
1285767293	RAYMOND TODD WHITE (Individual)	1422 MAIN ST STE 262 SOUTHLAKE, TX 76092 (817) 416-2961		Non-Participating Provider	NO
1316164510	REID ALAN DARNELL (Individual)	180 S WHITE CHAPEL BLVD SUITE 160 SOUTHLAKE, TX 76092 (817) 488-3020		Non-Participating Provider	NO
1316229271	TY SHAFER DDS PA SHAFER DENTAL (Organization)	311 W. SOUTHLAKE BLVD. SUITE 100 SOUTHLAKE, TX 76092 (817) 416-2228	Aetna CVS Health UnitedHealthcare	Non-Participating Provider	NO
1326132564	JOHN MICHAEL TATE (Individual)	3101 E STATE HIGHWAY 114 STE A SOUTHLAKE, TX 76092 (817) 481-6364		Non-Participating Provider	NO
1326257361	GREGORY BOB WRIGHT (Individual)	200 E SOUTHLAKE BLVD SUITE 30 SOUTHLAKE, TX 76092 (817) 481-7999		Non-Participating Provider	NO
1326318767	VICTORIA C HERON (Individual)	200 E SOUTHLAKE BLVD STE 30 SOUTHLAKE, TX 76092 (817) 481-7999		Non-Participating Provider	NO
1346269107	TY DOUGLAS SHAFER (Individual)	2000 E NORTHWEST PKWY SOUTHLAKE, TX 76092 (817) 416-2228	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	YES
1346732153	AMRITTEJ SINGH VIRK (Individual)	630 N KIMBALL AVE STE 110 SOUTHLAKE, TX 76092 (817) 251-9985	Aetna CVS Health Blue Cross and Blue Shield of Texas Blue Cross Blue Shield of Arizona	Accepts Medicare	YES
1356439061	RICHARD BRADLEY MOSS (Individual)	1011 N CARROLL AVE SOUTHLAKE, TX 76092 (817) 488-6513		Non-Participating Provider	YES
1356577795	RAED AL AJLOUNI (Individual)	100 W. SOUTHLAKE BLVD. STE 146 SOUTHLAKE, TX 76092 (817) 251-9333	Aetna CVS Health Guardian Humana	Opted out of Medicare	YES
1376636399	KURT MARSHALL CALENDER (Individual)	2001 W SOUTHLAKE BLVD SUITE #115 SOUTHLAKE, TX 76092 (817) 442-8282	Aetna CVS Health Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1376750166	THOMAS S BARKER (Individual)	271 E SOUTHLAKE BLVD STE 150 SOUTHLAKE, TX 76092 (817) 421-2437		Non-Participating Provider	NO
1376837807	JOHN TYLER TATE (Individual)	3101 E STATE HIGHWAY 114 STE A SOUTHLAKE, TX 76092 (817) 481-6364		Non-Participating Provider	YES
1386765675	TODD D STRICKLAND (Individual)	1100 E SOUTHLAKE BLVD 600 SOUTHLAKE, TX 76092 (817) 329-2791	Delta Dental PPO	Opted out of Medicare	YES
1386890648	TIMOTHY M. HUCKABEE, DDS, PC HUCKABEE DENTAL (Organization)	505 W SOUTHLAKE BLVD SOUTHLAKE, TX 76092 (817) 329-4746		Non-Participating Provider	NO
1427848563	CAMERON SAMUEL CARTER (Individual)	600 E SOUTHLAKE BLVD SOUTHLAKE, TX 76092 (817) 488-2273		Non-Participating Provider	NO
1437144292	DAISY KIT MOORE (Individual)	1101 E STATE HIGHWAY 114 SUITE 104 SOUTHLAKE, TX 76092 (817) 410-7373	Ambetter from Arizona Complete Health Ambetter from Arkansas Health & Wellness Ambetter from Louisiana Healthcare Connections Ambetter from Superior HealthPlan Ambetter of Oklahoma Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO EMI Health Florida Combined Life Humana Paramount Paramount Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	YES
1447470026	JAMES HOLT, DDS, PA (Organization)	600 E SOUTHLAKE BLVD #100 SOUTHLAKE, TX 76092 (817) 488-2273	Aetna CVS Health	Non-Participating Provider	NO
1457502429	TY SHAFER DDS PA SOUTHLAKE FAMILY DENTAL CARE (Organization)	2000 E HIGHWAY 114 SOUTHLAKE, TX 76092 (817) 416-2228	Ambetter from Arizona Complete Health Ambetter from Arkansas Health & Wellness Ambetter from Louisiana Healthcare Connections Ambetter from Superior HealthPlan Ambetter of Oklahoma UnitedHealthcare	Non-Participating Provider	NO
1467544213	RON D GROVES (Individual)	2105 W SOUTHLAKE BLVD SOUTHLAKE, TX 76092 (817) 481-2770		Non-Participating Provider	NO
1477083525	RENE EDUARDO AGUIRRE (Individual)	2645 E SOUTHLAKE BLVD STE 150 SOUTHLAKE, TX 76092 (817) 421-9999	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental Solstice Healthplans of Texas Inc. TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1477699031	J. LEE PETTIGREW (Individual)	201 PLAYERS CIRCLE SUITE #100 SOUTHLAKE, TX 76092 (817) 481-4888		Non-Participating Provider	YES
1477721728	SOUTHLAKE DENTAL CARE, PA (Organization)	500 W SOUTHLAKE BLVD STE 130 SOUTHLAKE, TX 76092 (817) 310-0310		Non-Participating Provider	NO
1487981072	TEXAS DENTAL HOLDINGS, PLLC (Organization)	500 W SOUTHLAKE BLVD #130 SOUTHLAKE, TX 76092 (817) 991-9478		Non-Participating Provider	NO
1497026728	GIGGLES & GRINS PEDIATRIC DENTISTRY, PLLC (Organization)	2915 E SOUTHLAKE BLVD SUITE 200 SOUTHLAKE, TX 76092 (817) 488-3533		Non-Participating Provider	NO
1508070095	GREG L GIST (Individual)	2379 N CARROLL AVE SOUTHLAKE, TX 76092 (817) 488-7512		Non-Participating Provider	NO
1558559609	TODD W REMMERS (Individual)	1100 E SOUTHLAKE BLVD SUITE 400 SOUTHLAKE, TX 76092 (817) 488-3636	Humana	Non-Participating Provider	NO
1568500197	DONALD MICHAEL MABRY (Individual)	271 E SOUTHLAKE BLVD SUITE #100 SOUTHLAKE, TX 76092 (817) 329-6677	Aetna CVS Health Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO Guardian Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	YES
1568641413	C. MICHAEL LARSEN (Individual)	1100 E SOUTHLAKE BLVD SUITE 400 SOUTHLAKE, TX 76092 (817) 488-3636	Delta Dental PPO	Non-Participating Provider	NO
1588116057	OBADAH ATTAR (Individual)	912 WINCHESTER DR SOUTHLAKE, TX 76092 (913) 499-9600	Aetna CVS Health Ambetter from Arizona Complete Health Ambetter from Arkansas Health & Wellness Ambetter from Louisiana Healthcare Connections Ambetter from Superior HealthPlan Ambetter of Oklahoma Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental Solstice Healthplans of Texas Inc. TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	YES
1598185928	REID DARNELL DDS PLLC (Organization)	1202 BRAZOS DR SOUTHLAKE, TX 76092 (817) 437-2302		Non-Participating Provider	NO
1619127461	ANN MARIE MAGGIO (Individual)	2915 E SOUTHLAKE BLVD STE 100 SOUTHLAKE, TX 76092 (817) 481-6553	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Humana	Non-Participating Provider	NO
1639193717	STANLEY THOMAS CZARNECKI (Individual)	754 N CARROLL AVE SOUTHLAKE, TX 76092 (817) 488-1150		Non-Participating Provider	NO
1689452278	ERKAN ONURLU (Individual)	1160 N KIMBALL AVE STE 110 SOUTHLAKE, TX 76092 (817) 251-9985	Aetna CVS Health	Accepts Medicare	YES
1720526916	ALEXIS B CAPECI (Individual)	2915 E SOUTHLAKE BLVD STE 200 SOUTHLAKE, TX 76092 (817) 488-3533	Aetna CVS Health Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1740779594	RADIANT FAMILY DENTAL PLLC (Organization)	2012 SOUTHLAKE GLEN DR. SOUTHLAKE, TX 76092 (504) 237-3558		Non-Participating Provider	NO
1750010237	TANNER WELBY DICE (Individual)	1845 E SOUTHLAKE BLVD # 144 SOUTHLAKE, TX 76092 (817) 554-1122		Non-Participating Provider	NO
1760172779	YEU JIN BAIK, D.D.S., P.C. (Organization)	271 E SOUTHLAKE BLVD STE 100 SOUTHLAKE, TX 76092 (817) 329-6677	UnitedHealthcare	Non-Participating Provider	NO
1760218853	BITA MARAGHEHPOUR (Individual)	1160 N KIMBALL AVE STE 100 SOUTHLAKE, TX 76092 (623) 980-2315		Accepts Medicare	YES
1770711392	OMS PHYSICIANS GROUP PLLC (Organization)	1422 MAIN ST SUITE 240 SOUTHLAKE, TX 76092 (817) 424-1166	Aetna CVS Health UnitedHealthcare	Non-Participating Provider	NO
1770914954	ANGELICA FRANK DDS PLLC DBA SOUTHLAKE FAMILY DENTAL CARE (Organization)	2000 E HIGHWAY 114 SOUTHLAKE, TX 76092 (817) 421-1444		Non-Participating Provider	NO
1770990194	HARDIK CHODAVADIA (Individual)	1025 CARROLL MEADOWS CT SOUTHLAKE, TX 76092 (817) 988-6484	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO EMI Health Guardian Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY	Non-Participating Provider	NO
1790094571	KURT CALENDER DMD, PA (Organization)	2001 W SOUTHLAKE BLVD STE 115 SOUTHLAKE, TX 76092 (817) 442-8282		Non-Participating Provider	NO
1790911691	PERLA DENTAL OF DESOTO (Organization)	1801 LANTANA CT SOUTHLAKE, TX 76092 (972) 223-3500	Aetna CVS Health Ambetter from Arizona Complete Health Ambetter from Arkansas Health & Wellness Ambetter from Louisiana Healthcare Connections Ambetter from Superior HealthPlan Ambetter of Oklahoma DentaQuest USA Insurance Company Inc.	Non-Participating Provider	NO
1801567441	AZUSA KUWASHIMA (Individual)	630 N KIMBALL AVE STE 110 SOUTHLAKE, TX 76092 (817) 251-9985	Aetna CVS Health	Accepts Medicare	YES
1811532435	GREGORY B WRIGHT DDS PA (Organization)	200 E SOUTHLAKE BLVD STE 30 SOUTHLAKE, TX 76092 (817) 481-7999		Non-Participating Provider	NO
1851274435	HAVEN DENTAL OF SOUTHLAKE, PLLC (Organization)	1845 E SOUTHLAKE BLVD # 144 SOUTHLAKE, TX 76092 (817) 554-1122		Non-Participating Provider	NO
1851358956	GREGORY DAVID TAYLOR (Individual)	1422 MAIN ST SUITE 240 SOUTHLAKE, TX 76092 (817) 424-1166	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO DeltaCare USA EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	YES
1851542815	ANGELICA FRANK (Individual)	2000 E HIGHWAY 114 SOUTHLAKE, TX 76092 (817) 421-1444	Ambetter from Arizona Complete Health Ambetter from Arkansas Health & Wellness Ambetter from Louisiana Healthcare Connections Ambetter from Superior HealthPlan Ambetter of Oklahoma Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO Humana Paramount Paramount Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1871515999	SEAN M. CERONE (Individual)	271 E SOUTHLAKE BLVD SUITE 150 SOUTHLAKE, TX 76092 (817) 421-2437	Aetna CVS Health Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Humana	Non-Participating Provider	NO
1881929552	RAJEEV MISRA (Individual)	840 SIMMONS COURT SOUTHLAKE, TX 76092 (817) 909-1023		Non-Participating Provider	NO
1891817821	STEPHEN P. ANDERSON (Individual)	2915 E SOUTHLAKE BLVD SUITE 100 SOUTHLAKE, TX 76092 (817) 481-6553		Non-Participating Provider	NO
1891880969	SANDRA LEE ARMSTRONG (Individual)	2915 E SOUTHLAKE BLVD #200 SOUTHLAKE, TX 76092 (817) 488-3533	Guardian	Non-Participating Provider	NO
1902055015	SANDRA LEE ARMSTRONG D.D.S, (Organization)	2915 E SOUTHLAKE BLVD SUITE 200 SOUTHLAKE, TX 76092 (817) 488-3533		Non-Participating Provider	NO
1912195769	TRACIE LYNN DAVIS (Individual)	271 E SOUTHLAKE BLVD SUITE 150 SOUTHLAKE, TX 76092 (817) 421-2437	Guardian	Non-Participating Provider	NO
1922021039	ROHINI KAUR BAJAJ (Individual)	480 W SOUTHLAKE BLVD STE #132 SOUTHLAKE, TX 76092 (817) 481-3737	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO DentaQuest USA Insurance Company Inc. Guardian Humana	Non-Participating Provider	NO
1922374263	HERZOG SOUTHLAKE PC FLOSS (Organization)	2600 E SOUTHLAKE BLVD SUITE 170 SOUTHLAKE, TX 76092 (817) 328-0110		Non-Participating Provider	NO
1922887793	BILL LUU DDS PLLC (Organization)	754 N CARROLL AVE SOUTHLAKE, TX 76092 (817) 488-1150		Non-Participating Provider	NO
1932349503	ROTH WYATT HINKLE (Individual)	201 PLAYERS CIR STE 100 SOUTHLAKE, TX 76092 (214) 704-5179	Aetna CVS Health Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Humana	Non-Participating Provider	NO
1982768271	TIMOTHY MICHAEL HUCKABEE (Individual)	505 W SOUTHLAKE BLVD SOUTHLAKE, TX 76092 (817) 329-4746		Non-Participating Provider	NO
1982797429	AMY WATTS (Individual)	2915 E SOUTHLAKE BLVD SUITE 200 SOUTHLAKE, TX 76092 (817) 488-3533	Guardian Humana	Non-Participating Provider	NO

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