Individual provider Active NPI

Jasmine Kaur Bains

  • Dentist
  • Fort Worth, TX
National Provider Identifier
1730925413
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
40527 Issued in TX
Practice address
9604 Ten Gallon Dr
Fort Worth, TX 76123-2186
Phone
(817) 803-4362
NPI assigned
Jul 2, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 40527 TX Primary

Addresses

Primary practice location

9604 Ten Gallon Dr
Fort Worth, TX 76123-2186

Mailing address

400 Grid Iron CV
Leander, TX 78641-5520

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
I20241014003165 TX Order and Referring Only - DentistPractitioner - Dentist 9638601701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dentists at Chisholm Trail, PC CurrentSince Jul 7, 2024 Accepting new patients

Locations

9604 Ten Gallon Dr
Fort Worth, TX 76123
Phone (817) 803-4362

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": "1719878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1730925413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 GRID IRON CV",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "786415520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9604 TEN GALLON DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761232186",
            "telephone_number": "817-803-4362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAINS",
        "first_name": "JASMINE",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "40527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.