Provider Demographics
NPI:1346526985
Name:JULIE DAVID TALAIVER DDS, PLLC
Entity type:Organization
Organization Name:JULIE DAVID TALAIVER DDS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:TALAIVER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-457-0638
Mailing Address - Street 1:4755 GRAMERCY OAKS DR
Mailing Address - Street 2:APT #421
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-5333
Mailing Address - Country:US
Mailing Address - Phone:214-457-0638
Mailing Address - Fax:
Practice Address - Street 1:650 BEEBALM LN
Practice Address - Street 2:STE #200
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-2955
Practice Address - Country:US
Practice Address - Phone:214-457-0638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX218911223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty