Lake Worth Center Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

LAKE WORTH CENTER DENTAL PLLC

Practice address

4601 Boat Club Rd
Fort Worth, TX 76135-7029

Phone

(972) 361-0600

NPI assigned

Dec 8, 2014

Organization subpart

No

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

Authorized official

Name

Sulman Ahmed, DMD

Title

Owner

Phone

(972) 361-0600

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417996800000",
    "number": "1710385745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 BOAT CLUB RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761357029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 BOAT CLUB RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761357029",
            "telephone_number": "972-361-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE WORTH CENTER DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-08",
        "last_updated": "2014-12-08",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "SULMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-361-0600",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Laird, PT, DPT
• Elizabeth Lakamp
• Lake Country Dental
• Lake Country Family Medicine, P.a.
• Lake Family and Cosmetic Dentistry
• Lake Worth Counseling
• Lake Worth Independent School District
• Lake Worth Investments Inc.
• Jeremy Michael Lake, PT
• Olivia Lake

• 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 Dec 8, 2014; 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.