Active NPI
Melody Nightingale Basta, DDS
- General Practice Dentistry
- Fort Worth, TX
National Provider Identifier
1174185268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 35160
- Practice address
- 5800 N Tarrant Pkwy Ste 102
Fort Worth, TX 76244-8003 - Phone
- (817) 581-6453
- NPI assigned
- Jun 28, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 35160 | TX | Primary |
Addresses
Primary practice location
5800 N Tarrant Pkwy Ste 102
Fort Worth, TX 76244-8003
Mailing address
7831 Southfork BND
Irving, TX 75063-4882
Phone (409) 543-3603
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35160 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561680000000",
"number": "1174185268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7831 SOUTHFORK BND",
"city": "IRVING",
"state": "TX",
"postal_code": "750634882",
"telephone_number": "409-543-3603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5800 N TARRANT PKWY STE 102",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "762448003",
"telephone_number": "817-581-6453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASTA",
"first_name": "MELODY",
"middle_name": "NIGHTINGALE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-28",
"last_updated": "2019-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "35160",
"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 Jun 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.