Active NPI
Omar Alassaf
- Dentist
- Fort Worth, TX
National Provider Identifier
1710470455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 33924
- Practice address
- 9716 Blue Mound Rd
Fort Worth, TX 76131-3301 - Phone
- (682) 204-0031
- Fax
- (682) 204-0031
- NPI assigned
- Jun 7, 2018
- Last updated
- Aug 4, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 33924 | TX | Primary |
Addresses
Primary practice location
9716 Blue Mound Rd
Fort Worth, TX 76131-3301
Mailing address
4801 Spring Valley Rd Ste 30
Farmers Branch, TX 75244-8242
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Desktop |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33924 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alassaf Dental PLLC | Current | Accepting new patients | |
| Aa Emergency Dental | Past | Accepting new patients |
Locations
9716 Blue Mound Rd
Fort Worth, TX 76131
Phone (682) 204-0031
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Emergency Dental Care USA
- Dental Clinic/Center
- Centennial, CO
- NPI 1578975207
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754265600000",
"number": "1710470455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4801 SPRING VALLEY RD STE 30",
"city": "FARMERS BRANCH",
"state": "TX",
"postal_code": "752448242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9716 BLUE MOUND RD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761313301",
"telephone_number": "682-204-0031",
"fax_number": "682-204-0031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALASSAF",
"first_name": "OMAR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-07",
"last_updated": "2025-08-04",
"certification_date": "2025-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "33924",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Desktop",
"affiliation": "N",
"address_1": "5720 Mountain Stream Trl",
"city": "Fort Worth",
"state": "TX",
"country_code": "US",
"postal_code": "762445165",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Aug 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.