Abc123 Dental in Haltom PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

24570 Issued in TX

Legal business name

ABC123 DENTAL IN HALTOM PLLC

Doing business as

ABC123 Dental

Practice address

5416 Basswood Blvd
Fort Worth, TX 76137-4400

Phone

(817) 656-1215

Fax

(877) 687-6861

NPI assigned

Aug 16, 2011

Last updated

Aug 16, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tri H Pham, DDS

Title

Owner/Dentist

Phone

(817) 656-1215

Specialties & licenses 1

Addresses

Other names 1

• ABC123 Dental Doing business as

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313452800000",
    "number": "1740569144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5416 BASSWOOD BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761374400",
            "telephone_number": "817-656-1215",
            "fax_number": "877-687-6861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5416 BASSWOOD BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761374400",
            "telephone_number": "817-656-1215",
            "fax_number": "877-687-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABC123 DENTAL IN HALTOM PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-16",
        "last_updated": "2011-08-16",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "TRI",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "817-656-1215",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "24570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABC123 Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vanessa Abbood, MS, RD, LD
• Abbott Clinic, PA
• Jacob Clifford Abbott, D.D.S.
• Kendall Abbott, LMSW
• Abc 123 Dental Centers Professional (ABC 123 Dental and Orthodontics)
• Nancy Abdelmeseh
• Abeer Marwan Abdelrahim, MD, MPH
• Abdi's Healthcare Corp
• Pardis Abdollahi Zarandi
• Aziz Samir Abdul-Rahim, M.D.

• 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 Aug 16, 2011; 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.