Organization Active NPI

Ty Dental Haltom City PLLC

  • General Practice Dentistry
  • Haltom City, TX
National Provider Identifier
1023973070
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TY DENTAL HALTOM CITY PLLC
Practice address
3101 Denton Hwy Ste 100
Haltom City, TX 76117-3706
Phone
(469) 458-7342
NPI assigned
Dec 22, 2025
Last updated
Oct 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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

Authorized official

Name
Tien Phan, DMD
Title
Owner
Phone
(408) 835-3726

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU
Endodontics 1223E0200X NU
General Practice Dentistry 1223G0001X NU Primary
Oral and Maxillofacial Pathology Dentistry 1223P0106X NU
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU

Addresses

Primary practice location

3101 Denton Hwy Ste 100
Haltom City, TX 76117-3706

Mailing address

3050 Regent Blvd Ste 110
Irving, TX 75063-3107
Phone (956) 507-7253

National Provider Directory

National Provider Directory

Locations

3101 Denton Hwy
Ste 100
Haltom City, TX 76117
Phone (817) 831-1567

NPI Registry JSON

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

{
    "created_epoch": "1766361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791417600000",
    "number": "1023973070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 REGENT BLVD STE 110",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633107",
            "telephone_number": "956-507-7253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 DENTON HWY STE 100",
            "city": "HALTOM CITY",
            "state": "TX",
            "postal_code": "761173706",
            "telephone_number": "469-458-7342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TY DENTAL HALTOM CITY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-22",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "TIEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-835-3726",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haltom City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.

Verify at the official NPI Registry.