OrganizationActive
Advanced Southlake Endodontics, PLLC
NPI 1730331778 · Dental Clinic/Center · Southlake, TX
Provider details
- NPI number
- 1730331778
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Charles Larsen, Member(817) 488-3636
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1100 E Southlake Blvd
Suite 400
Southlake, TX 76092-6357
Phone: (817) 488-3636
Fax: (817) 421-2372
Street-level locationGet directions
Mailing address
1100 E Southlake Blvd
Southlake, TX 76092-6357
Other names (DBA / former)
- Doing business as
- Southlake Endodontics
Registry dates
- Enumerated
- 2008-10-22
- Last updated
- 2008-10-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.