Dental Boat Club P.C

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

22593 Issued in TX

Legal business name

DENTAL BOAT CLUB P.C

Practice address

4625 Boat Club Rd
Ste 225
Fort Worth, TX 76135-7022

Phone

(817) 666-8110

NPI assigned

Mar 27, 2012

Last updated

Mar 27, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Haiduong H Nguyen, DDSNPI 1841339603

Title

Owner

Phone

(213) 862-0106

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Haiduong H Nguyen, DDS

  • General Practice Dentistry
  • Fort Worth, TX
  • NPI 1841339603
  NPD (past) Authorized official

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1306112149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4625 BOAT CLUB RD.",
            "address_2": "SUITE 225",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "75135",
            "telephone_number": "817-666-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 BOAT CLUB RD",
            "address_2": "STE 225",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761357022",
            "telephone_number": "817-666-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL BOAT CLUB P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-27",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "HAIDUONG",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-862-0106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "TX",
            "license": "22593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Denny
• Molly Marie Denny
• Regan Nicole Denova, PA-C
• Toni Lyn Denson, MD
• Dental Associates of Fort Worth
• Dental Choice 2 PLLC (Ellis Dental)
• Dental Health Associates of Texas, PC (Harris Southwest Dental)
• Dental Health Associates of Texas, PC (Dental Care at Tehama Ridge)
• Dental Health Associates of Texas, PC (Bluebonnet Dental Care)
• Dental Health Associates of Texas, PC

• Preferred Provider Organization in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Preferred Provider Organization in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; 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.