Tarrant Dental Group PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

TARRANT DENTAL GROUP PLLC

Practice address

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

Phone

(817) 849-9777

Fax

(817) 887-2722

NPI assigned

Jul 14, 2022

Organization subpart

No

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

Authorized official

Name

Andrew Xu, DDS

Title

Member Manager

Phone

(646) 662-3105

Specialties & licenses 1

Addresses

Other names 1

• Texas Endodontic Center - Tarrant Doing business as

Locations

Practitioners 2

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

• Pei Kang, DDS, PHD

  • Endodontics
  • Fort Worth, TX
  • NPI 1588719124
  NPD
• Ali Waadallah Altitinchi

  • Endodontics
  • Fortworth, TX
  • NPI 1043935125
  NPD (past)

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

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1679207641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 LEGACY DR STE 240",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243112",
            "telephone_number": "646-662-3105"
        },
        {
            "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",
            "fax_number": "817-887-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARRANT DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-14",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "XU",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "646-662-3105",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Texas Endodontic Center - Tarrant",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tarrant County Public Health
• Tarrant County Public Health Dept.
• Tarrant County Samaritan Housing, Inc.
• Tarrant County Senior Living Center, Inc.
• Tarrant County Surgical Center LLC
• Tarrant Diagnostic Imaging, LLC
• Tarrant Emergency Physicians
• Tarrant Family Practice P.a
• Tarrant Gastroenterology Associates PA
• Tarrant Home Health Care, LLC

• Dentist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.