Crest Family Dental Fort Worth PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22755 Issued in TX

Legal business name

CREST FAMILY DENTAL FORT WORTH PLLC

Practice address

220 E Seminary Dr
Suite 100
Fort Worth, TX 76115-2607

Phone

(817) 484-6468

NPI assigned

May 18, 2016

Organization subpart

No

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

Authorized official

Name

Lan CHI Le, DDS

Title

Managing Member

Phone

(214) 350-8800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463529600000",
    "number": "1104273341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2823 KENDALE DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752204736",
            "telephone_number": "214-350-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 E SEMINARY DR",
            "address_2": "SUITE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761152607",
            "telephone_number": "817-484-6468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREST FAMILY DENTAL FORT WORTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-05-18",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "LAN CHI",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "214-350-8800",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Creative Solutions Counseling, PLLC
• Creative Solutions in Healthcare, Inc.
• Creators Mind Cares4Us
• Benjamin Creighton, BCBA
• Stephen R Creme, MD
• Carey B Cribbs, MD
• Erin Cribbs, PA
• Randall William Cribbs
• Nathan Boone Crick
• H Carolyn Crighton, M.D.

• 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 May 18, 2016; 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.