Active NPI
John Bradford Struble, D.D.S.
- General Practice Dentistry
- Willow Park, TX
National Provider Identifier
1447447586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 15876
- Practice address
- 209 Canyon CT
Willow Park, TX 76087-3203 - Phone
- (817) 441-1211
- Fax
- (817) 441-1202
- NPI assigned
- Oct 3, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 15876 | TX | Primary |
Addresses
Primary practice location
209 Canyon CT
Willow Park, TX 76087-3203
Mailing address
4700 Annetta Centerpoint Rd
Willow Park, TX 76008-2762
Phone (817) 247-6571
Other practice location 1
250 W Lancaster Ave Ste 130
Fort Worth, TX 76102-6364
Phone (817) 877-3131
Other practice location 2
1833 Cannon Dr
Mansfield, TX 76063-3482
Phone (817) 477-4441
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15876 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| S2 Dental | Past | Accepting new patients |
Organizations & group practices 1
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": "1191369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769472000000",
"number": "1447447586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 ANNETTA CENTERPOINT RD",
"city": "WILLOW PARK",
"state": "TX",
"postal_code": "760082762",
"telephone_number": "817-247-6571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 CANYON CT",
"city": "WILLOW PARK",
"state": "TX",
"postal_code": "760873203",
"telephone_number": "817-441-1211",
"fax_number": "817-441-1202"
}
],
"practiceLocations": [
{
"address_1": "250 W Lancaster Ave Ste 130",
"address_purpose": "LOCATION",
"city": "Fort Worth",
"state": "TX",
"postal_code": "761026364",
"country_code": "US",
"telephone_number": "817-877-3131",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1833 Cannon Dr",
"address_purpose": "LOCATION",
"city": "Mansfield",
"state": "TX",
"postal_code": "760633482",
"country_code": "US",
"telephone_number": "817-477-4441",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STRUBLE",
"first_name": "JOHN",
"middle_name": "BRADFORD",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-03",
"last_updated": "2026-01-27",
"certification_date": "2026-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "15876",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willow Park, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.