NPIMap

Organization Active NPI

Hometown Dental at Ridgemar

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1013275585
Registry record updated May 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15987 Issued in TX
Legal business name
HOMETOWN DENTAL AT RIDGEMAR
Practice address
2374 Mall Cir
Fort Worth, TX 76116-1543
Phone
(817) 543-2222
Fax
(817) 543-2299
NPI assigned
May 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Melody Vargas
Title
Inusrance Coordinator
Phone
(817) 834-2600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 15987 TX Primary

Addresses

Primary practice location

2374 Mall Cir
Fort Worth, TX 76116-1543

Mailing address

3825 Yucca Ave
Suite 121
Fort Worth, TX 76111-6067
Phone (817) 834-2600

National Provider Directory

National Provider Directory

Locations

2374 Mall Cir
Fort Worth, TX 76116
Phone (817) 543-2222

3825 Yucca Ave
Ste 121
Fort Worth, TX 76111
Phone (817) 927-8500

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335916800000",
    "number": "1013275585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 YUCCA AVE",
            "address_2": "SUITE 121",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761116067",
            "telephone_number": "817-834-2600",
            "fax_number": "817-834-2607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2374 MALL CIR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761161543",
            "telephone_number": "817-543-2222",
            "fax_number": "817-543-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMETOWN DENTAL AT RIDGEMAR",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-02",
        "last_updated": "2012-05-02",
        "status": "A",
        "authorized_official_last_name": "VARGAS",
        "authorized_official_first_name": "MELODY",
        "authorized_official_title_or_position": "INUSRANCE COORDINATOR",
        "authorized_official_telephone_number": "817-834-2600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "15987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.