NPIMap

Organization Active NPI

Brident DDS PC

  • Dentist
  • Fort Worth, TX
National Provider Identifier
1629762455
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
BRIDENT DDS PC
Practice address
9021 Tehama Ridge Pkwy
Ft Worth, TX 76177-2002
Phone
(714) 571-2140
Fax
(714) 571-6445
NPI assigned
Jun 5, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Authorized official

Name
Bill Dembereckyj
Title
Executive Vice President
Phone
(714) 571-6445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

9021 Tehama Ridge Pkwy
Ft Worth, TX 76177-2002

Mailing address

530 S Main St
Orange, CA 92868-4525
Phone (714) 480-3000

National Provider Directory

National Provider Directory
Tax ID family
Brident DDS PC21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Locations

9021 Tehama Ridge Pkwy
Ft Worth, TX 76177
Phone (714) 571-2140

NPI Registry JSON

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685923200000",
    "number": "1629762455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 S MAIN ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684525",
            "telephone_number": "714-480-3000",
            "fax_number": "714-571-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9021 TEHAMA RIDGE PKWY",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761772002",
            "telephone_number": "714-571-2140",
            "fax_number": "714-571-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDENT DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A",
        "authorized_official_last_name": "DEMBERECKYJ",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "714-571-6445"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "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 Jun 5, 2023; 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.