Individual provider Active NPI

Pei Kang, DDS, PHD

  • Endodontics
  • Fort Worth, TX
National Provider Identifier
1588719124
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
21918 Issued in TX
Practice address
5310 N Tarrant Pkwy Ste 104
Fort Worth, TX 76244-5386
Phone
(817) 849-9777
NPI assigned
Jan 24, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 21918 TX Primary

Addresses

Primary practice location

5310 N Tarrant Pkwy Ste 104
Fort Worth, TX 76244-5386

Mailing address

5310 N Tarrant Pkwy Ste 104
Fort Worth, TX 76244-5386
Phone (817) 849-9777

Other practice location 1

1000 N Fielder Rd
Arlington, TX 76012-3149
Phone (817) 277-6601

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
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Tarrant Dental Group PLLC CurrentSince Jul 24, 2022 Accepting new patients

Locations

5310 North Tarrant Pkwy
Ste 104
Fort Worth, TX 76244
Phone (817) 581-4867

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1588719124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 N TARRANT PKWY STE 104",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445386",
            "telephone_number": "817-849-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 N TARRANT PKWY STE 104",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445386",
            "telephone_number": "817-849-9777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 N Fielder Rd",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760123149",
            "country_code": "US",
            "telephone_number": "817-277-6601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANG",
        "first_name": "PEI",
        "credential": "DDS, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "21918",
            "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 Jul 21, 2022; 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.