Active NPI
Dream Haven Extensions
- Durable Medical Equipment & Medical Supplies
- Fort Worth, TX
National Provider Identifier
1023945136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- DREAM HAVEN EXTENSIONS
- Practice address
- 4500 Mercantile Plaza Dr # 17147172
Fort Worth, TX 76137-4225 - Phone
- (214) 635-6412
- NPI assigned
- May 5, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dream Haven Extensions
- Title
- Manager
- Phone
- (214) 635-6412
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
4500 Mercantile Plaza Dr # 17147172
Fort Worth, TX 76137-4225
Mailing address
4500 Mercantile Plaza Dr # 17147172
Fort Worth, TX 76137-4225
Phone (214) 635-6412
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1777939200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1777939200000",
"number": "1023945136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 MERCANTILE PLAZA DR # 17147172",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761374225",
"telephone_number": "214-635-6412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 MERCANTILE PLAZA DR # 17147172",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761374225",
"telephone_number": "214-635-6412"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DREAM HAVEN EXTENSIONS",
"organizational_subpart": "NO",
"enumeration_date": "2026-05-05",
"last_updated": "2026-05-05",
"certification_date": "2026-05-05",
"status": "A",
"authorized_official_last_name": "EXTENSIONS",
"authorized_official_first_name": "DREAM",
"authorized_official_middle_name": "HAVEN",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "214-635-6412"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"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 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.