Individual provider Active NPI

Nicole Christine Branca, DDS

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1609069897
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22774 Issued in TX
Practice address
1628 Basswood Blvd
Fort Worth, TX 76131
Phone
(817) 618-2060
NPI assigned
Aug 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22774 TX Primary

Addresses

Primary practice location

1628 Basswood Blvd
Fort Worth, TX 76131

Mailing address

5609 Sleepy Creek Lane
Fort Worth, TX 76179-7526
Phone (817) 239-7522

Other practice location 1

1050 5th Ave Ste G
Fort Worth, TX 76104-2903
Phone (817) 332-9700

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
I20160218001134 TX Order and Referring Only - DentistPractitioner - Dentist 3072818749

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
David J.W. Sorokolit DDS 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": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1609069897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5609 SLEEPY CREEK LANE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761797526",
            "telephone_number": "817-239-7522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 BASSWOOD BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76131",
            "telephone_number": "817-618-2060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 5th Ave Ste G",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761042903",
            "country_code": "US",
            "telephone_number": "817-332-9700",
            "fax_number": "817-332-9768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANCA",
        "first_name": "NICOLE",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.