NPIMap

Organization Active NPI

Magnolia Dental

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1497912661
Registry record updated May 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19770 Issued in TX
Legal business name
MAGNOLIA DENTAL
Practice address
6758 McCart Ave
Fort Worth, TX 76133-6357
Phone
(817) 292-6203
Fax
(817) 292-6279
NPI assigned
May 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2008

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

Authorized official

Name
Dr. Tin Truong Tran, D.D.S.NPI 1619196839
Title
President
Phone
(817) 292-6203

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 19770 TX Primary

Addresses

Primary practice location

6758 McCart Ave
Fort Worth, TX 76133-6357

Mailing address

6758 McCart Ave
Fort Worth, TX 76133-6357
Phone (817) 292-6203

National Provider Directory

National Provider Directory

Locations

6758 McCart Ave
Fort Worth, TX 76133
Phone (817) 292-6203

Practitioners & affiliated clinicians

Practitioners 2

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": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1497912661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6758 MCCART AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761336357",
            "telephone_number": "817-292-6203",
            "fax_number": "817-292-6279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6758 MCCART AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761336357",
            "telephone_number": "817-292-6203",
            "fax_number": "817-292-6279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "TIN",
        "authorized_official_middle_name": "TRUONG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-292-6203",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "19770",
            "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 May 16, 2008; 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.