NPIMap

Organization Active NPI

Ideal Dental of Fort Worth, PLLC

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1437407392
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
IDEAL DENTAL OF FORT WORTH, PLLC
Practice address
12584 N Beach St
Suite 150
Fort Worth, TX 76244-4249
Phone
(817) 337-0021
NPI assigned
Aug 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

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

Authorized official

Name
Dr. Rodney Alles, DDS
Title
Owner
Phone
(817) 337-0021

Specialties & licenses 1

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

Addresses

Primary practice location

12584 N Beach St
Suite 150
Fort Worth, TX 76244-4249

Mailing address

12584 N Beach St
Suite 150
Fort Worth, TX 76244-4249
Phone (817) 337-0021

National Provider Directory

National Provider Directory

Locations

12584 N Beach St
Ste 150
Fort Worth, TX 76244
Phone (817) 337-0021

Practitioners & affiliated clinicians

Practitioners 3

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": "1346025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346889600000",
    "number": "1437407392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12584 N BEACH ST",
            "address_2": "SUITE 150",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762444249",
            "telephone_number": "817-337-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12584 N BEACH ST",
            "address_2": "SUITE 150",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762444249",
            "telephone_number": "817-337-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL DENTAL OF FORT WORTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-27",
        "last_updated": "2012-09-06",
        "status": "A",
        "authorized_official_last_name": "ALLES",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-337-0021",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 6, 2012; 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.