Family Dental and Orthodontics Ft Worth St Grand Prairie PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FAMILY DENTAL AND ORTHODONTICS FT WORTH ST GRAND PRAIRIE PLLC

Practice address

1017 Fort Worth St
100
Grand Prairie, TX 75050-5402

Phone

(214) 412-2595

NPI assigned

Oct 18, 2013

Organization subpart

No

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

Authorized official

Name

Steven Thompson

Title

DDS

Phone

(972) 512-0285

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1382054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382918400000",
    "number": "1629406145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15110 DALLAS PKWY",
            "address_2": "SUITE 470",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752484635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 FORT WORTH ST",
            "address_2": "100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750505402",
            "telephone_number": "214-412-2595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL AND ORTHODONTICS FT WORTH ST GRAND PRAIRIE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-18",
        "last_updated": "2013-10-28",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "972-512-0285"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Grand Prairie, TX
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2013; 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.