Individual provider Active NPI

Carol Elizabeth Lazell, D.D.S.

  • Dentist
  • Fort Worth, TX
National Provider Identifier
1487808457
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6721 Issued in CO
Practice address
7551 Oakmont Blvd
Fort Worth, TX 76132
Phone
(817) 292-9348
NPI assigned
Nov 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6721 CO Primary

Addresses

Primary practice location

7551 Oakmont Blvd
Fort Worth, TX 76132

Mailing address

7551 Oakmont Blvd
Fort Worth, TX 76132-4207
Phone (817) 292-9348

Other practice location 1

1470 Jersey St
Denver, CO 80220-2652
Phone (303) 377-1280

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
I20210628000364 TX Practitioner - Dentist 8426459512 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14871TXMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Longview Wellness Center Inc CurrentSince May 17, 2021 Accepting new patients
Longview Wellness Center, Inc Current Accepting new patients
Longview Wellness Center, Inc. CurrentSince May 17, 2021 Accepting new patients
Americas Children Dental Clinic Past Accepting new patients
Dental Health Associates of Texas, PC. Past Accepting new patients
Longview Wellness Center Inc PastSince Jan 2, 2022 Accepting new patients

Locations

1107 E Marshall Ave
Longview, TX 75601
Phone (903) 212-4763

1701 Pine Tree Rd
Longview, TX 75604
Phone (903) 295-5151

Organizations & group practices 6

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": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1487808457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7551 OAKMONT BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324207",
            "telephone_number": "817-292-9348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7551 OAKMONT BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76132",
            "telephone_number": "817-292-9348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1470 Jersey St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802202652",
            "country_code": "US",
            "telephone_number": "303-377-1280",
            "fax_number": "303-377-1662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAZELL",
        "first_name": "CAROL",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-04",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "6721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.