Individual provider Active NPI

Bob X. Jing, DDS

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1104040740
Registry record updated Sep 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19270 Issued in TX
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
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
19270TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fifth Dental Partner PLLC General Practice Current Accepting new patients
Bob Jing DDS PA General Practice Current Accepting new patients
Bob Jing D.D.S P.a. Current Accepting new patients

Locations

2246 Jacksboro Hwy
Ste 112
Fort Worth, TX 76114
Phone (214) 738-1528

115 W Seminary Dr
Ste 101
Fort Worth, TX 76115
Phone (817) 405-0195

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 and National Provider Directory roles.

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.

Verify at the official NPI Registry.