Organization Active NPI

Ismile Dental at the Chisolm Trail PLLC

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1205440146
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ISMILE DENTAL AT THE CHISOLM TRAIL PLLC
Practice address
5513 Sycamore School Rd
Fort Worth, TX 76123
Phone
(817) 899-6311
NPI assigned
Sep 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Authorized official

Name
Dr. Long Nguyen
Title
Owner
Phone
(512) 571-8961

Specialties & licenses 1

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

Addresses

Primary practice location

5513 Sycamore School Rd
Fort Worth, TX 76123

Mailing address

5513 Sycamore School Rd
Fort Worth, TX 76123
Phone (817) 899-6311

National Provider Directory

National Provider Directory

Locations

5513 Sycamore School Rd
Fort Worth, TX 76123
Phone (817) 899-6311

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599523200000",
    "number": "1205440146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5513 SYCAMORE SCHOOL RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76123",
            "telephone_number": "817-899-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5513 SYCAMORE SCHOOL RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76123",
            "telephone_number": "817-899-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISMILE DENTAL AT THE CHISOLM TRAIL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-08",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-02",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "LONG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-571-8961",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "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 Sep 8, 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.