NPIMap

Organization Active NPI

South Texas Dental Associates, LP

  • General Practice Dentistry
  • Ft Worth, TX
National Provider Identifier
1689015505
Registry record updated Jul 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16570 Issued in TX
Legal business name
SOUTH TEXAS DENTAL ASSOCIATES, LP
Practice address
2482 Jacksboro Hwy
Ft Worth, TX 76114-2201
Phone
(817) 626-4867
NPI assigned
Jul 8, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2013

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

Authorized official

Name
Dr. Barry Gomel, DDS
Title
Officer/Partner
Phone
(713) 457-3445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 16570 TX Primary

Addresses

Primary practice location

2482 Jacksboro Hwy
Ft Worth, TX 76114-2201

Mailing address

6300 West Loop S Ste 650
Bellaire, TX 77401-2997
Phone (713) 457-3445

National Provider Directory

National Provider Directory
Tax ID family
South Texas Dental Associates LP39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

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

View all 38

Locations

2482 Jacksboro Hwy
Ft Worth, TX 76114
Phone (817) 626-4867

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373241600000",
    "number": "1689015505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 WEST LOOP S STE 650",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774012997",
            "telephone_number": "713-457-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2482 JACKSBORO HWY",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761142201",
            "telephone_number": "817-626-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH TEXAS DENTAL ASSOCIATES, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-08",
        "last_updated": "2013-07-08",
        "status": "A",
        "authorized_official_last_name": "GOMEL",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "OFFICER/PARTNER",
        "authorized_official_telephone_number": "713-457-3445",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "16570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.