Uptown Endodontics, PA

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

18969 Issued in TX

Legal business name

UPTOWN ENDODONTICS, PA

Practice address

906 N Fielder Rd
Arlington, TX 76012-3195

Phone

(817) 461-4292

Fax

(817) 276-0229

NPI assigned

Jun 18, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Jill Peterson, DDS

Title

Owner

Phone

(817) 461-4292

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1275063638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 NORTH FIELDER ROAD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "76012",
            "telephone_number": "817-461-4292",
            "fax_number": "817-276-0229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 N FIELDER RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760123195",
            "telephone_number": "817-461-4292",
            "fax_number": "817-276-0229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPTOWN ENDODONTICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-461-4292",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "18969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.