# RADIANCE DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902105711
- **Authorized official:** DR. MOUNIR ISKANDAR BDS,MSD (DENTIST)
- **Authorized official phone:** (972) 258-1702

## Contact information

- **Practice address:** 1235 KINWEST PKWY, IRVING, TX 75063-3403
- **Practice address phone:** (972) 258-1702
- **Practice address fax:** (972) 258-1703
- **Mailing address:** 1235 KINWEST PKWY, IRVING, TX 75063-3403
- **Mailing address phone:** (972) 258-1702
- **Mailing address fax:** (972) 258-1703

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 23921 | TX | — |
| 1223P0700X | Prosthodontics | — | NULL | Yes |
| 1223P0700X | Prosthodontics | — | — | Yes |

## Other

- **Enumeration date:** 03/18/2011
- **Last updated:** 11/23/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 27805703 | — | TX |