Active NPI
Candace Lee Kretschmer, DDS
- General Practice Dentistry
- Azle, TX
National Provider Identifier
1225762305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 38781
- Practice address
- 912 Boyd Rd
Azle, TX 76020-2516 - Phone
- (817) 444-1763
- NPI assigned
- Jul 13, 2022
- Last updated
- Jul 30, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 38781 | TX | Primary |
Addresses
Primary practice location
912 Boyd Rd
Azle, TX 76020-2516
Mailing address
461 Rayner Ave
Fort Worth, TX 76111-1624
Phone (281) 701-2940
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 |
|---|---|---|---|
| 38781 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Erika Hallock DDS PA | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722297600000",
"number": "1225762305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "461 RAYNER AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761111624",
"telephone_number": "281-701-2940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "912 BOYD RD",
"city": "AZLE",
"state": "TX",
"postal_code": "760202516",
"telephone_number": "817-444-1763"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRETSCHMER",
"first_name": "CANDACE",
"middle_name": "LEE",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-13",
"last_updated": "2024-07-30",
"certification_date": "2024-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "38781",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Azle, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.