Fall Creek Dental PA

Primary specialty

DentistTaxonomy code 122300000X

License

19566 Issued in TX

Legal business name

FALL CREEK DENTAL PA

Practice address

5600 N Gate Rd
Suite 103
Granbury, TX 76049-3120

Phone

(817) 326-5717

Fax

(817) 326-5714

NPI assigned

Mar 5, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Katrina Ladawn McFadden, D.D.S.NPI 1235288259

Title

Owner/Dentist

Phone

(817) 326-5717

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Katrina L McFadden, DDS

  • General Practice Dentistry
  • Granbury, TX
  • NPI 1235288259
  NPD (past) Authorized official

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330905600000",
    "number": "1649544966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 N GATE RD",
            "address_2": "SUITE 103",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760493120",
            "telephone_number": "817-326-5717",
            "fax_number": "817-326-5714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 N GATE RD",
            "address_2": "SUITE 103",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760493120",
            "telephone_number": "817-326-5717",
            "fax_number": "817-326-5714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALL CREEK DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-05",
        "last_updated": "2012-03-05",
        "status": "A",
        "authorized_official_last_name": "MCFADDEN",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_middle_name": "LADAWN",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "817-326-5717",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "19566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009483101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL CHIPS",
            "identifier": "B19566",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Erica Espinoza, LCSW
• Natalie Evans
• Family First Chiropractic Wellness Center
• Courtney Feist, FNP
• Ibimina Fiberesima
• Karen Lynn Finch, PTA
• Katrina Fisher, D.D.S.

• Dentist in Granbury, TX
• Providers in Granbury, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2012; 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.