Organization Active NPI

Fort Worth Endodontics

  • Endodontics
  • Fort Worth, TX
National Provider Identifier
1083979462
Registry record updated Jul 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
25792 Issued in TX
Legal business name
FORT WORTH ENDODONTICS
Practice address
4545 Bellaire Dr S Ste 8
Fort Worth, TX 76109-1811
Phone
(817) 735-1981
NPI assigned
Jul 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2012

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

Authorized official

Name
Dr. John Walker Loeffelholz, D.D.S. , M.S.
Title
Member
Phone
(817) 735-1981

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 25792 TX Primary

Addresses

Primary practice location

4545 Bellaire Dr S Ste 8
Fort Worth, TX 76109-1811

Mailing address

4545 Bellaire Dr S Ste 8
Fort Worth, TX 76109-1811
Phone (817) 735-1981

National Provider Directory

National Provider Directory

Locations

4545 Bellaire Dr S
Ste 8
Fort Worth, TX 76109
Phone (817) 332-8400

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341964800000",
    "number": "1083979462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 BELLAIRE DR S STE 8",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091811",
            "telephone_number": "817-735-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 BELLAIRE DR S STE 8",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091811",
            "telephone_number": "817-735-1981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WORTH ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-11",
        "last_updated": "2012-07-11",
        "status": "A",
        "authorized_official_last_name": "LOEFFELHOLZ",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WALKER",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "817-735-1981",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S. , M.S."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "25792",
            "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 Jul 11, 2012; 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.