Individual provider Active NPI

Frank Rubal

  • General Practice Dentistry
  • Azle, TX
National Provider Identifier
1699796417
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
18676 Issued in TX
Practice address
209 W Main St
Azle, TX 76020-3177
Phone
(817) 444-2585
Fax
(817) 444-4254
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 18676 TX Primary

Addresses

Primary practice location

209 W Main St
Azle, TX 76020-3177

Mailing address

209 W Main St
Azle, TX 76020-3177
Phone (817) 444-2585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150701000182 TX Order and Referring Only - DentistPractitioner - Dentist 2961714175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18676TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Todays Dental, P.a. General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1699796417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W MAIN ST",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760203177",
            "telephone_number": "817-444-2585",
            "fax_number": "817-444-4254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W MAIN ST",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760203177",
            "telephone_number": "817-444-2585",
            "fax_number": "817-444-4254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBAL",
        "first_name": "FRANK",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "18676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Azle, TX

Sources for this page

Verify at the official NPI Registry.