NPIMap

Organization Active NPI

Western Dental

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1548495443
Registry record updated May 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19711 Issued in TX
Legal business name
WESTERN DENTAL
Practice address
1501 Handley Dr
Fort Worth, TX 76112
Phone
(817) 457-4141
Fax
(817) 457-4142
NPI assigned
May 20, 2009
Last updated
May 20, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2009

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

Authorized official

Name
Dr. Hossain Dezham
Title
Owner
Phone
(817) 457-4141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 19711 TX Primary

Addresses

Primary practice location

1501 Handley Dr
Fort Worth, TX 76112

Mailing address

1501 Handley Dr
Fort Worth, TX 76112-3328
Phone (817) 457-4141

National Provider Directory

National Provider Directory
Tax ID family
Western Dental5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242777600000",
    "number": "1548495443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 HANDLEY DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761123328",
            "telephone_number": "817-457-4141",
            "fax_number": "817-457-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HANDLEY DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76112",
            "telephone_number": "817-457-4141",
            "fax_number": "817-457-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-20",
        "last_updated": "2009-05-20",
        "status": "A",
        "authorized_official_last_name": "DEZHAM",
        "authorized_official_first_name": "HOSSAIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-457-4141",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "19711",
            "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 20, 2009; 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.