NPIMap

Organization Active NPI

Decatur Family Dental PA

  • General Practice Dentistry
  • Hurst, TX
National Provider Identifier
1245542992
Registry record updated Jul 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20467 Issued in TX
Legal business name
DECATUR FAMILY DENTAL PA
Doing business as
Decatur Family Dental PA
Practice address
1801 Precinct Line Rd
Suite a
Hurst, TX 76054-3170
Phone
(817) 577-9200
Fax
(817) 281-9231
NPI assigned
Jul 10, 2010
Last updated
Jul 10, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2010

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

Authorized official

Name
Dr. Kevin Afkami, DDS
Title
President
Phone
(817) 577-9200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 20467 TX Primary

Addresses

Primary practice location

1801 Precinct Line Rd
Suite a
Hurst, TX 76054-3170

Mailing address

1801 Precinct Line Rd
Suite a
Hurst, TX 76054-3170
Phone (817) 577-9200

Other names 1

  • Decatur Family Dental PA Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Decatur Family Dental PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1278720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278720000000",
    "number": "1245542992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 PRECINCT LINE RD",
            "address_2": "SUITE A",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760543170",
            "telephone_number": "817-577-9200",
            "fax_number": "817-281-9231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 PRECINCT LINE RD",
            "address_2": "SUITE A",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760543170",
            "telephone_number": "817-577-9200",
            "fax_number": "817-281-9231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR FAMILY DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-10",
        "last_updated": "2010-07-10",
        "status": "A",
        "authorized_official_last_name": "AFKAMI",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-577-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Decatur Family Dental PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hurst, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2010; 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.