Organization Active NPI

Bella Family Dentistry PLLC

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1710575485
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
BELLA FAMILY DENTISTRY PLLC
Doing business as
Bella Family Dentistry PLLC
Practice address
5159 Wichita St Ste 170
Fort Worth, TX 76119-5686
Phone
(682) 326-0186
NPI assigned
Jan 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Authorized official

Name
Dr. Jamal F Khatib, DDSNPI 1457525032
Title
Officer
Phone
(682) 326-0186

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

5159 Wichita St Ste 170
Fort Worth, TX 76119-5686

Mailing address

5159 Wichita St Ste 170
Fort Worth, TX 76119-5686
Phone (682) 326-0186

Other names 1

  • Bella Family Dentistry PLLC Doing business as

National Provider Directory

National Provider Directory

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": "1609977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609977600000",
    "number": "1710575485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5159 WICHITA ST STE 170",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761195686",
            "telephone_number": "682-326-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5159 WICHITA ST STE 170",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761195686",
            "telephone_number": "682-326-0186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLA FAMILY DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-07",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A",
        "authorized_official_last_name": "KHATIB",
        "authorized_official_first_name": "JAMAL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "682-326-0186",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bella Family Dentistry PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 7, 2021; 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.