NPIMap

Organization Active NPI

Creekside Dental Center

  • General Practice Dentistry
  • Arlington, TX
National Provider Identifier
1306976451
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16733 Issued in TX
Legal business name
CREEKSIDE DENTAL CENTER
Practice address
2356 SE Green Oaks Blvd
Ste 192
Arlington, TX 76018-0924
Phone
(817) 417-0655
Fax
(817) 468-8834
NPI assigned
Mar 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Hoang Richard Nghiem, DDSNPI 1477671972
Title
President
Phone
(817) 417-0655

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 16733 TX Primary

Addresses

Primary practice location

2356 SE Green Oaks Blvd
Ste 192
Arlington, TX 76018-0924

Mailing address

2356 SE Green Oaks Blvd
Ste 192
Arlington, TX 76018-0924
Phone (817) 417-0655

Other identifiers 3

IdentifierTypeStateIssuer
84D494OtherTXBLUE CROSS #
104717OtherPAUNITED CONCORDIA PROV. #
23461OtherUTUNITED HEALTHCARE #

National Provider Directory

National Provider Directory

Locations

2356 SE Green Oaks Blvd
Ste 192
Arlington, TX 76018
Phone (817) 417-0655

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": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306976451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2356 SE GREEN OAKS BLVD",
            "address_2": "STE 192",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760180924",
            "telephone_number": "817-417-0655",
            "fax_number": "817-468-8834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2356 SE GREEN OAKS BLVD",
            "address_2": "STE 192",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760180924",
            "telephone_number": "817-417-0655",
            "fax_number": "817-468-8834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NGHIEM",
        "authorized_official_first_name": "HOANG",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-417-0655",
        "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": "16733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS #",
            "identifier": "84D494",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROV. #",
            "identifier": "104717",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE #",
            "identifier": "23461",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.