NPIMap

Organization Active NPI

Affordable Dentist Near Me PLLC

  • Dental Clinic/Center
  • Fort Worth, TX
National Provider Identifier
1760234165
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
AFFORDABLE DENTIST NEAR ME PLLC
Practice address
3307 Miller Ave Ste a
Fort Worth, TX 76119-1971
Phone
(817) 383-1450
NPI assigned
Apr 1, 2024
Last updated
Apr 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Authorized official

Name
Phuong DO, DDSNPI 1417171281
Title
Doctor
Phone
(817) 437-6661

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

3307 Miller Ave Ste a
Fort Worth, TX 76119-1971

Mailing address

3307 Miller Ave Ste a
Fort Worth, TX 76119-1971
Phone (817) 383-1450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180410001166 TX Part B Supplier - Clinic/Group Practice 0345503199 Receives reassigned benefits from 2 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Crowley, TX; Grand Prairie, TX; Fort Worth, TX

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Affordable Dentist Near Me PLLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the 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": "1711929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711929600000",
    "number": "1760234165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3307 MILLER AVE STE A",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761191971",
            "telephone_number": "817-383-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3307 MILLER AVE STE A",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761191971",
            "telephone_number": "817-383-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE DENTIST NEAR ME PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A",
        "authorized_official_last_name": "DO",
        "authorized_official_first_name": "PHUONG",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "817-437-6661",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.