KTV Dental , PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

23133 Issued in TX

Legal business name

KTV DENTAL , PA

Doing business as

Cowtown Dental

Practice address

2717 8TH Ave.
Fort Worth, TX 76110

Phone

(954) 591-0298

NPI assigned

Nov 17, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Kim Thi Van, D.M.D

Title

President

Phone

(954) 591-0298

Specialties & licenses 1

Addresses

Other names 1

• Cowtown Dental Doing business as

Locations

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

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226880000000",
    "number": "1225282320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 SARA JANE PKWY APT 333",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750528604",
            "telephone_number": "954-591-0298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 8TH AVE.",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76110",
            "telephone_number": "954-591-0298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KTV DENTAL , PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-17",
        "last_updated": "2008-11-17",
        "status": "A",
        "authorized_official_last_name": "VAN",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "THI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-591-0298",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cowtown Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Keith Krukowski, D.C., CNIM
• Goldie Ann Krulik, PA
• Amber Leigh Krumholtz, DPT
• Ellisa Krumm, MD
• Jonas Kruse
• Harlington Peter Ku, D.D.S, P.A.
• Jacques Kubaluka
• Ashli Kubista, RN
• Rachel Christine Kuchem, LCSW
• Dhaatri Kuchipudi, DO

• General Practice Dentistry in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2008; 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.