Timber Creek Orthodontics, P.a.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

20625 Issued in TX

Legal business name

TIMBER CREEK ORTHODONTICS, P.A.

Practice address

12650 N Beach St
Suite 100
Fort Worth, TX 76244-4243

Phone

(817) 562-3292

NPI assigned

Oct 26, 2011

Organization subpart

No

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

Authorized official

Name

Daniel C Mallory, D.D.S., M.S.

Title

Orthodontist

Phone

(817) 562-3292

Specialties & licenses 1

Addresses

Practitioners 1

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

• Timothy Sterling Casey, D.D.S.

  • Dentist
  • Fort Worth, TX
  • NPI 1295981892
  NPD (past)

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319587200000",
    "number": "1063798718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12650 N BEACH ST",
            "address_2": "SUITE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762444243",
            "telephone_number": "817-562-3292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12650 N BEACH ST",
            "address_2": "SUITE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762444243",
            "telephone_number": "817-562-3292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMBER CREEK ORTHODONTICS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-26",
        "last_updated": "2011-10-26",
        "status": "A",
        "authorized_official_last_name": "MALLORY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "817-562-3292",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "20625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael David Tillman, DDS
• Tricia Tillman
• Cally Lynn Tilly, LPC
• Tim P Kret OD, PA (1st Eye Care)
• Timber Creek Dental & Orthodontics (Timber Creek Dental)
• Timeless Care Homes LLC
• Timely Telehealth, LLC
• Benjamin James Timmer, DO
• Julie Lynn Timmerman, CRNA
• Christopher Scott Timms, LPC-ASSOCIATE

• Orthodontics and Dentofacial Orthopedics Dentistry in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; 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.