Individual provider Active NPI

Tiffany C Ford, D.D.S.

  • Dentist
  • Fort Cavazos, TX
National Provider Identifier
1164783668
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30-024070 Issued in OH
Practice address
USA Dentac Health Activity Fort Cavazos
36000 Shoemaker Lane Suite 1051
Fort Cavazos, TX 76544-5054
Phone
(254) 287-2705
NPI assigned
Jun 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30-024070 OH Primary

Addresses

Primary practice location

USA Dentac Health Activity Fort Cavazos
36000 Shoemaker Lane Suite 1051
Fort Cavazos, TX 76544-5054

Mailing address

USA Dentac Health Activity Fort Cavazos
36000 Shoemaker Lane Suite 1051
Fort Cavazos, TX 76544
Phone (254) 287-2705

Other practice location 1

228 Beeman Pl
Fort Riley, KS 66442-7009
Phone (267) 975-8064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260603002324 OH Order and Referring Only - DentistPractitioner - Dentist 4284950114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30-024070OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1338508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1164783668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "USA DENTAC HEALTH ACTIVITY FORT CAVAZOS",
            "address_2": "36000 SHOEMAKER LANE SUITE 1051",
            "city": "FORT CAVAZOS",
            "state": "TX",
            "postal_code": "76544",
            "telephone_number": "254-287-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "USA DENTAC HEALTH ACTIVITY FORT CAVAZOS",
            "address_2": "36000 SHOEMAKER LANE SUITE 1051",
            "city": "FORT CAVAZOS",
            "state": "TX",
            "postal_code": "765445054",
            "telephone_number": "254-287-2705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "228 Beeman Pl",
            "address_purpose": "LOCATION",
            "city": "Fort Riley",
            "state": "KS",
            "postal_code": "664427009",
            "country_code": "US",
            "telephone_number": "267-975-8064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORD",
        "first_name": "TIFFANY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-01",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-024070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Cavazos, TX

Sources for this page

Verify at the official NPI Registry.