NPIMap

Organization Active NPI

Brident Dental Associates PC

  • Dentist
  • Fort Worth, TX
National Provider Identifier
1376016469
Registry record updated Jan 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
BRIDENT DENTAL ASSOCIATES PC
Practice address
815 E Berry St Ste B
Fort Worth, TX 76110-4457
Phone
(817) 920-5919
Fax
(817) 920-5970
NPI assigned
Jan 10, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2019

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

Authorized official

Name
Maribel Zamora
Title
Enrollment Coordinator
Phone
(714) 571-3104

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

815 E Berry St Ste B
Fort Worth, TX 76110-4457

Mailing address

530 S Main St Ste 600
Orange, CA 92868-4544
Phone (714) 480-3000

Other identifiers 1

IdentifierTypeStateIssuer
G60850MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Brident Dental Associates PC44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Practitioners & affiliated clinicians

Practitioners 2

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": "1547078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547078400000",
    "number": "1376016469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 S MAIN ST STE 600",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684544",
            "telephone_number": "714-480-3000",
            "fax_number": "714-571-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 E BERRY ST STE B",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761104457",
            "telephone_number": "817-920-5919",
            "fax_number": "817-920-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDENT DENTAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-10",
        "last_updated": "2019-01-10",
        "status": "A",
        "authorized_official_last_name": "ZAMORA",
        "authorized_official_first_name": "MARIBEL",
        "authorized_official_title_or_position": "ENROLLMENT COORDINATOR",
        "authorized_official_telephone_number": "714-571-3104"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G60850",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jan 10, 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.