Trinity Family Dental

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

22368 Issued in TX

Legal business name

TRINITY FAMILY DENTAL

Practice address

800 N Industrial Blvd
Suite 103
Euless, TX 76039-7400

Phone

(817) 283-3801

Fax

(817) 283-6309

NPI assigned

Sep 9, 2008

Last updated

Sep 9, 2008By 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

Jasdeep J Walia, DDSNPI 1295873305

Title

General Dentist

Phone

(817) 283-3801

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Jasdeep J Walia, DDS

  • General Practice Dentistry
  • Euless, TX
  • NPI 1295873305
  NPD (past) Authorized official

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220918400000",
    "number": "1750539276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N INDUSTRIAL BLVD",
            "address_2": "SUITE 103",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760397400",
            "telephone_number": "817-283-3801",
            "fax_number": "817-283-6309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N INDUSTRIAL BLVD",
            "address_2": "SUITE 103",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760397400",
            "telephone_number": "817-283-3801",
            "fax_number": "817-283-6309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-09",
        "last_updated": "2008-09-09",
        "status": "A",
        "authorized_official_last_name": "WALIA",
        "authorized_official_first_name": "JASDEEP",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "817-283-3801",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "TX",
            "license": "22368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Euless, TX
• Providers in Euless, TX by specialty
• Preferred Provider Organization in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.