NPIMap

Organization Active NPI

FTWH Dental PLLC

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1306490156
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FTWH DENTAL PLLC
Practice address
6600 North Fwy Ste 109
Fort Worth, TX 76137-7556
Phone
(972) 679-3630
NPI assigned
Jul 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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

Authorized official

Name
Sukhraj Khassa
Title
Manager
Phone
(269) 753-9600

Specialties & licenses 1

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

Addresses

Primary practice location

6600 North Fwy Ste 109
Fort Worth, TX 76137-7556

Mailing address

6600 North Fwy Ste 109
Fort Worth, TX 76137-7556
Phone (972) 679-3630

Other names 1

  • PURE THEORY DENTAL Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1564444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564444800000",
    "number": "1306490156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 NORTH FWY STE 109",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761377556",
            "telephone_number": "972-679-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 NORTH FWY STE 109",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761377556",
            "telephone_number": "972-679-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FTWH DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-30",
        "last_updated": "2019-07-30",
        "status": "A",
        "authorized_official_last_name": "KHASSA",
        "authorized_official_first_name": "SUKHRAJ",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "269-753-9600"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PURE THEORY DENTAL",
            "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 Jul 30, 2019; 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.