Individual provider Active NPI

Maureen Limosnero, DDS

  • Dentist
  • Ft Worth, TX
National Provider Identifier
1407945876
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
28653 Issued in TX
Practice address
400 N Beach St Ste 100
Ft Worth, TX 76111-7070
Phone
(817) 916-5237
Fax
(817) 916-4660
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D7681 OR
Dentist 122300000X 28653 TX Primary

Addresses

Primary practice location

400 N Beach St Ste 100
Ft Worth, TX 76111-7070

Mailing address

6255 W Sunset Blvd FL 21
Los Angeles, CA 90028-7422
Phone (323) 860-5200

Other practice location 1

5110 Heritage Ave
Colleyville, TX 76034-5910
Phone (817) 318-5600

Other identifiers 2

IdentifierTypeStateIssuer
181134MedicaidOR
911019392OtherCOMMERCIAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220316002524 TX Practitioner - Dentist 0547655276 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D7681ORMDGeneral Practice Dentistry
28653TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
AIDS Healthcare Foundation CurrentSince Aug 17, 2025 Accepting new patients
AIDS Outreach Center CurrentSince Mar 3, 2022 Accepting new patients

Locations

6255 W Sunset Blvd
Fl 21
Los Angeles, CA 90028
Phone (323) 860-5200

400 N Beach St
Ste 100
Ft Worth, TX 76111
Phone (817) 335-1994

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1407945876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 W SUNSET BLVD FL 21",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287422",
            "telephone_number": "323-860-5200",
            "fax_number": "323-467-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N BEACH ST STE 100",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761117070",
            "telephone_number": "817-916-5237",
            "fax_number": "817-916-4660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5110 Heritage Ave",
            "address_purpose": "LOCATION",
            "city": "Colleyville",
            "state": "TX",
            "postal_code": "760345910",
            "country_code": "US",
            "telephone_number": "817-318-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIMOSNERO",
        "first_name": "MAUREEN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7681",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "28653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181134",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "911019392",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Worth, TX

Sources for this page

Verify at the official NPI Registry.