NPIMap

Organization Active NPI

Sebyuk Dentistry

  • Dentist
  • Fort Worth, TX
National Provider Identifier
1295600112
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SEBYUK DENTISTRY
Practice address
5040 N Tarrant Pkwy Ste 118
Fort Worth, TX 76244-5390
Phone
(817) 750-5433
NPI assigned
Oct 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Authorized official

Name
Sebyuk Kim, DMDNPI 1841843430
Title
Owner Dentist
Phone
(502) 791-4630

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

5040 N Tarrant Pkwy Ste 118
Fort Worth, TX 76244-5390

Mailing address

5040 N Tarrant Pkwy Ste 118
Fort Worth, TX 76244-5390
Phone (817) 750-5433

Other names 1

  • Lifetime Cosmetic Dentistry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1759968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759968000000",
    "number": "1295600112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5040 N TARRANT PKWY STE 118",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445390",
            "telephone_number": "817-750-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5040 N TARRANT PKWY STE 118",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445390",
            "telephone_number": "817-750-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEBYUK DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-09",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SEBYUK",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "502-791-4630",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifetime Cosmetic Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 9, 2025; 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.