NPIMap

Organization Active NPI

Lifeway Dental

  • Dentist
  • Alvarado, TX
National Provider Identifier
1194143016
Registry record updated Mar 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14855 Issued in TX
Legal business name
LIFEWAY DENTAL
Practice address
505 E Hwy 67
Alvarado, TX 76009
Phone
(817) 587-8888
NPI assigned
Mar 29, 2014
Last updated
Mar 29, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
ALSBURY DENTALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 29, 2014

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

Authorized official

Name
Blake Foust, DDS
Title
Owner
Phone
(817) 587-8888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14855 TX Primary

Addresses

Primary practice location

505 E Hwy 67
Alvarado, TX 76009

Mailing address

505 E Hwy 67
Alvarado, TX 76009
Phone (817) 587-8888

National Provider Directory

National Provider Directory
Tax ID family
Lifeway Dental2 organizations share this tax ID, including this one
Part of
Lifeway Dental

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1396051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396051200000",
    "number": "1194143016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 E HWY 67",
            "city": "ALVARADO",
            "state": "TX",
            "postal_code": "76009",
            "telephone_number": "817-587-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E HWY 67",
            "city": "ALVARADO",
            "state": "TX",
            "postal_code": "76009",
            "telephone_number": "817-587-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWAY DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALSBURY DENTAL",
        "enumeration_date": "2014-03-29",
        "last_updated": "2014-03-29",
        "status": "A",
        "authorized_official_last_name": "FOUST",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-587-8888",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "14855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alvarado, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2014; 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.