Seminary Dental Clinic P. a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21968 Issued in TX

Legal business name

SEMINARY DENTAL CLINIC P. A.

Practice address

4763 Barwick Dr.
Suite 106
Fort Worth, TX 76132

Phone

(817) 926-5485

Fax

(817) 926-5523

NPI assigned

Feb 18, 2008

Last updated

Nov 15, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mita Desai, DDSNPI 1770573594

Title

Owner

Phone

(817) 926-5485

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mita Desai, DDS

  • General Practice Dentistry
  • Fort Worth, TX
  • NPI 1770573594
  NPD (past) Authorized official

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

{
    "created_epoch": "1203292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542240000000",
    "number": "1033387501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4763 BARWICK DR.",
            "address_2": "SUITE 106",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76132",
            "telephone_number": "817-926-5485",
            "fax_number": "817-926-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4763 BARWICK DR.",
            "address_2": "SUITE 106",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76132",
            "telephone_number": "817-926-5485",
            "fax_number": "817-926-5523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEMINARY DENTAL CLINIC P. A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-18",
        "last_updated": "2018-11-15",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "MITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-926-5485",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Selwyn Ronea Stewart-Winrow, PSYD, PLLC
• Asa Brent Selzer, D.D.S.
• Kody Selzer, M.D.
• Mary C Selzer, N.P.
• Sara Maria Semborski, LCSW
• Seminary Family Dental PLLC
• Summer J Semmens
• Meaghan Danielle Semple, LPC
• Steven J. Senevey, M.D.
• Alice Senff

• General Practice Dentistry in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; 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.