NPIMap

Organization Active NPI

Lake Worth Pediatric Dentistry, PLLC

  • Pediatric Dentistry
  • Lake Worth, TX
National Provider Identifier
1720661689
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
LAKE WORTH PEDIATRIC DENTISTRY, PLLC
Practice address
7109 Navajo TRL
Lake Worth, TX 76135-3946
Phone
(817) 238-6450
NPI assigned
Apr 29, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Authorized official

Name
Dr. Michael Ball, DDSNPI 1699209742
Title
Owner/Partner
Phone
(817) 995-3195

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

7109 Navajo TRL
Lake Worth, TX 76135-3946

Mailing address

7109 Navajo TRL
Lake Worth, TX 76135-3946
Phone (817) 238-6450

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1720661689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7109 NAVAJO TRL",
            "city": "LAKE WORTH",
            "state": "TX",
            "postal_code": "761353946",
            "telephone_number": "817-238-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7109 NAVAJO TRL",
            "city": "LAKE WORTH",
            "state": "TX",
            "postal_code": "761353946",
            "telephone_number": "817-238-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE WORTH PEDIATRIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "BALL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "817-995-3195",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.