Individual provider Active NPI

Olena Razo, DDS

  • Dentist
  • Fort Worth, TX
National Provider Identifier
1215311774
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
31223 Issued in TX
Practice address
5800 N Tarrant Pkwy Ste 102
Fort Worth, TX 76244-8003
Phone
(817) 581-6453
NPI assigned
Jul 15, 2015
Last updated
Mar 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 31223 TX Primary

Addresses

Primary practice location

5800 N Tarrant Pkwy Ste 102
Fort Worth, TX 76244-8003

Mailing address

5800 N Tarrant Pkwy Ste 102
Fort Worth, TX 76244-8003
Phone (817) 581-6453

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

LicenseStateTypeSpecialty
31223TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1215311774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 N TARRANT PKWY STE 102",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448003",
            "telephone_number": "817-581-6453"
        },
        {
            "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": "RAZO",
        "first_name": "OLENA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-15",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "31223",
            "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 Mar 8, 2016; 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.