NPIMap

Organization Active NPI

JP Dental Group PLLC

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1154716587
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
29792 Issued in TX
Legal business name
JP DENTAL GROUP PLLC
Practice address
3613 Hulen St
Fort Worth, TX 76107-6813
Phone
(267) 210-2725
NPI assigned
Apr 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2015

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

Authorized official

Name
Jin Park
Title
DMD
Phone
(267) 210-2725

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 29792 TX Primary

Addresses

Primary practice location

3613 Hulen St
Fort Worth, TX 76107-6813

Mailing address

3613 Hulen St
Fort Worth, TX 76107-6813

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427932800000",
    "number": "1154716587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3613 HULEN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3613 HULEN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076813",
            "telephone_number": "267-210-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JP DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-02",
        "last_updated": "2015-04-02",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JIN",
        "authorized_official_title_or_position": "DMD",
        "authorized_official_telephone_number": "267-210-2725"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "29792",
            "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 Apr 2, 2015; 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.