Willow Tree Dental, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22233 Issued in TX

Legal business name

WILLOW TREE DENTAL, PLLC

Practice address

1205 E Debbie LN
Suite 111
Mansfield, TX 76063-3356

Phone

(214) 636-8434

NPI assigned

Jan 26, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Rupal D Bhakta, DDS

Title

Dentist

Phone

(214) 636-8434

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296000000000",
    "number": "1124324991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 E DEBBIE LN",
            "address_2": "SUITE 111",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 E DEBBIE LN",
            "address_2": "SUITE 111",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633356",
            "telephone_number": "214-636-8434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW TREE DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-26",
        "last_updated": "2011-01-26",
        "status": "A",
        "authorized_official_last_name": "BHAKTA",
        "authorized_official_first_name": "RUPAL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "214-636-8434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Jean Williams, CPM, LM
• Tyah Chantyce Williams, MS, LPC ASSOCIATE
• Vonteshea L Williams, MS, LPC ASSOCIATE
• John M Willis, DO
• Willow & Stone Integrative Mental Health PLLC
• Andrea Leigh Wilson, N.P.
• Auralila Wilson, LPC-A
• Catherine Wardlow Wimbrey, LPC
• Win Psychiatry
• Winners Home Health LLC (Winners Home Care Services)

• General Practice Dentistry in Mansfield, TX
• Providers in Mansfield, 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 Jan 26, 2011; 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.