Active NPI
Bob X. Jing, DDS
- General Practice Dentistry
- Fort Worth, TX
National Provider Identifier
1104040740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 19270
- Practice address
- 2246 Jacksboro Hwy
Ste 112
Fort Worth, TX 76114-2330 - Phone
- (214) 738-1528
- Fax
- (214) 987-9446
- NPI assigned
- Apr 13, 2007
- Last updated
- Sep 11, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 19270 | TX | Primary |
Addresses
Primary practice location
2246 Jacksboro Hwy
Ste 112
Fort Worth, TX 76114-2330
Mailing address
2925 Westminster Ave
Dallas, TX 75205-1508
Phone (214) 738-1528
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19270 | TX | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bob Jing D.D.S P.a. | Current | Accepting new patients | |
| Bob Jing DDS PA | General Practice | Current | Accepting new patients |
| Fifth Dental Partner PLLC | General Practice | Current | Accepting new patients |
Locations
115 W Seminary Dr
Ste 101
Fort Worth, TX 76115
Phone (817) 405-0195
2246 Jacksboro Hwy
Ste 112
Fort Worth, TX 76114
Phone (214) 738-1528
Organizations & group practices 3
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221091200000",
"number": "1104040740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2925 WESTMINSTER AVE",
"city": "DALLAS",
"state": "TX",
"postal_code": "752051508",
"telephone_number": "214-738-1528",
"fax_number": "214-987-9446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2246 JACKSBORO HWY",
"address_2": "STE 112",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761142330",
"telephone_number": "214-738-1528",
"fax_number": "214-987-9446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JING",
"first_name": "BOB",
"middle_name": "X.",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-13",
"last_updated": "2008-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "19270",
"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 Sep 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.