Organization Active NPI

Covenant Dental Care PLLC

  • Dentist
  • Fort Worth, TX
National Provider Identifier
1124836986
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
COVENANT DENTAL CARE PLLC
Practice address
512 W Bonds Ranch Rd Ste 100
Fort Worth, TX 76131-3914
Phone
(817) 204-6686
NPI assigned
Dec 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Authorized official

Name
Mark Mehany, DDSNPI 1790355311
Title
Managing Member
Phone
(817) 204-6686

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

512 W Bonds Ranch Rd Ste 100
Fort Worth, TX 76131-3914

Mailing address

2300 Windsor CT
Bedford, TX 76022-7858

Other names 1

  • Covenant Dental Doing business as

National Provider Directory

National Provider Directory

Locations

512 W Bonds Ranch Rd
Ste 100
Fort Worth, TX 76131
Phone (817) 204-6686

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": "1735171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747180800000",
    "number": "1124836986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 WINDSOR CT",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760227858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 W BONDS RANCH RD STE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761313914",
            "telephone_number": "817-204-6686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT DENTAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-26",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A",
        "authorized_official_last_name": "MEHANY",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "817-204-6686",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covenant Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 14, 2025; 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.