Texas Wisdom Teeth Specialists

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

TEXAS WISDOM TEETH SPECIALISTS

Practice address

8409 W Cleburne Rd
Fort Worth, TX 76123-1421

Phone

(214) 814-1057

NPI assigned

Nov 4, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Mark A Benage, DDSNPI 1205186525

Title

General Dentist

Phone

(972) 786-4307

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark A Benage, DDS

  • Dentist
  • Jber, AK
  • NPI 1205186525
  NPD Authorized official

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604880000000",
    "number": "1134720337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 CIRCLE CLUB LN",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756024866",
            "telephone_number": "903-445-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8409 W CLEBURNE RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761231421",
            "telephone_number": "214-814-1057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS WISDOM TEETH SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-04",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A",
        "authorized_official_last_name": "BENAGE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "972-786-4307",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Texas United Health Group
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• Texas Uvc Medical PLLC (United Vein & Vascular Centers)
• Texas Varicose Vein Clinic of Fort Worth, LLC (Gateway Vein & Leg Center)
• Suzanne Deegan Tezanos, DPT
• TH of Waco LLC (Texas Hospice)
• Carolyn Wanjiku Thairu, RN
• Karishma H Thakor, D.O.
• Kathryn Thalken

• Oral and Maxillofacial Surgery (Dentist) in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.