Ray D Snider, D.D.S., P.A.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12073 Issued in TX

Practice address

8461 Boat Club Rd
Fort Worth, TX 76179-3607

Phone

(817) 236-8771

Fax

(817) 236-8791

NPI assigned

Oct 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lake Country Dental

  • Dentist
  • Fort Worth, TX
  • NPI 1972692556
  NPD (past) Authorized official

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083703672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8509 WOODLAKE CIR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761793143",
            "telephone_number": "817-236-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8461 BOAT CLUB RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761793607",
            "telephone_number": "817-236-8771",
            "fax_number": "817-236-8791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNIDER",
        "first_name": "RAY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.D.S., P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "12073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER #",
            "identifier": "D12073",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIAPROVIDER#",
            "identifier": "841904",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lyn Snell, PHYSICAL THERAPIST
• Joshua Snellgrove
• Brock Snelson, PHARMD
• Cappy Snider
• Kristin Michelle Snider, FNP-BC
• Jennifer Lindsey Snook, MPT
• Snoring and Sleep Apnea Wellness Center, LLC
• Alvin Snorton
• Brianna Snow, LCSW
• Jonathon Snow

• 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 Jul 8, 2007; 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.