Individual provider Active NPI

Sommay Siripanyo, DDS

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1427160506
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16600 Issued in TX
Practice address
2332 N Riverside Dr
Fort Worth, TX 76111-2903
Phone
(817) 838-0099
Fax
(817) 838-8509
NPI assigned
Aug 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 16600 TX Primary

Addresses

Primary practice location

2332 N Riverside Dr
Fort Worth, TX 76111-2903

Mailing address

2332 N Riverside Dr
Fort Worth, TX 76111-2903
Phone (817) 838-0099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 2, 2015 through Jul 2, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16600TXMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427160506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2332 N RIVERSIDE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761112903",
            "telephone_number": "817-838-0099",
            "fax_number": "817-838-8509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2332 N RIVERSIDE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761112903",
            "telephone_number": "817-838-0099",
            "fax_number": "817-838-8509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRIPANYO",
        "first_name": "SOMMAY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "16600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.