Organization Active NPI

Birth Fletcher Oral Surgery Keller

  • Oral and Maxillofacial Surgery (Dentist)
  • Fort Worth, TX
National Provider Identifier
1053743518
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
19486 Issued in TX
Legal business name
BIRTH FLETCHER ORAL SURGERY KELLER
Practice address
4420 Heritage Trace Pkwy Ste 300
Fort Worth, TX 76244-8904
Phone
(817) 479-0541
NPI assigned
Aug 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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

Authorized official

Name
Dr. Cristi Fletcher, DDS, MS
Title
Orthodontist
Phone
(817) 479-0541

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 22279 TX
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 19486 TX Primary

Addresses

Primary practice location

4420 Heritage Trace Pkwy Ste 300
Fort Worth, TX 76244-8904

Mailing address

4420 Heritage Trace Pkwy Ste 300
Fort Worth, TX 76244-8904
Phone (817) 479-0541

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1375747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383523200000",
    "number": "1053743518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 HERITAGE TRACE PKWY STE 300",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448904",
            "telephone_number": "817-479-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 HERITAGE TRACE PKWY STE 300",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448904",
            "telephone_number": "817-479-0541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIRTH FLETCHER ORAL SURGERY KELLER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-06",
        "last_updated": "2013-11-04",
        "status": "A",
        "authorized_official_last_name": "FLETCHER",
        "authorized_official_first_name": "CRISTI",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "817-479-0541",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "22279",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "19486",
            "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 Nov 4, 2013; 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.