NPIMap

Organization Active NPI

Pure Dental Specialist, PLLC

Doing business as Berry Pure Family Dental

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1073144309
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PURE DENTAL SPECIALIST, PLLC
Doing business as
Berry Pure Family Dental
Practice address
3829 E Loop 820 S
Fort Worth, TX 76119-4339
Phone
(214) 821-6468
NPI assigned
Jan 27, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Authorized official

Name
Field Harrison
Title
Owner
Phone
(214) 821-6468

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3829 E Loop 820 S
Fort Worth, TX 76119-4339

Mailing address

3201 W Airport Fwy Ste 102
Irving, TX 75062-5928
Phone (972) 893-8730

Other names 1

  • Berry Pure Family Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Berry Pure Family Dental8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5307 E Mockingbird Ln
#325
Dallas, TX 75206
Phone (214) 416-8406

3829 E Loop 820 S
Fort Worth, TX 76119
Phone (469) 212-1707

NPI Registry JSON

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1073144309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 W AIRPORT FWY STE 102",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750625928",
            "telephone_number": "972-893-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3829 E LOOP 820 S",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761194339",
            "telephone_number": "214-821-6468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE DENTAL SPECIALIST, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "FIELD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-821-6468"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Berry Pure Family Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Berry Pure Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 5, 2020; 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.