NPIMap

Organization Active NPI

Altamesa Dental

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1689901704
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23259 Issued in TX
Legal business name
ALTAMESA DENTAL
Practice address
3608 Altamesa Blvd
Fort Worth, TX 76133-5641
Phone
(817) 294-0877
NPI assigned
Nov 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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

Authorized official

Name
Dr. Asa Selzer, D.D.S.
Title
Partner
Phone
(817) 294-0877

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 23259 TX Primary

Addresses

Primary practice location

3608 Altamesa Blvd
Fort Worth, TX 76133-5641

Mailing address

3608 Altamesa Blvd
Fort Worth, TX 76133-5641

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1257811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257811200000",
    "number": "1689901704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3608 ALTAMESA BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761335641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3608 ALTAMESA BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761335641",
            "telephone_number": "817-294-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTAMESA DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-10",
        "last_updated": "2009-11-10",
        "status": "A",
        "authorized_official_last_name": "SELZER",
        "authorized_official_first_name": "ASA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "817-294-0877",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23259",
            "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 Nov 10, 2009; 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.