Provider Demographics
NPI:1912569815
Name:SOROKOLIT, CARA (DMD)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:SOROKOLIT
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 HULEN ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-6141
Mailing Address - Country:US
Mailing Address - Phone:817-765-1600
Mailing Address - Fax:
Practice Address - Street 1:3401 HULEN ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-6141
Practice Address - Country:US
Practice Address - Phone:817-765-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36176122300000X, 1223G0001X
FL243471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist