Organization Active NPI

Dentists at Chisholm Trail, PC

Doing business as Dentists at Chisholm Trail

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1770118911
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTISTS AT CHISHOLM TRAIL, PC
Doing business as
Dentists at Chisholm Trail
Practice address
9604 Ten Gallon Dr
Fort Worth, TX 76123-2186
Phone
(817) 803-4362
Fax
(817) 803-4090
NPI assigned
Mar 9, 2020
Last updated
Jun 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Authorized official

Name
Dr. Joyanna Hoffman, DMD
Title
Owner
Phone
(817) 803-4362

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

9604 Ten Gallon Dr
Fort Worth, TX 76123-2186

Mailing address

PO Box 920050
Dallas, TX 75392-0050
Phone (714) 845-8890

Other names 1

  • Dentists at Chisholm Trail Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2321138Dentists at Chisholm Trail9604 Ten Gallon Dr, Fort Worth, TX 76123Certificate of waiverMar 30, 2027

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 4

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": "1583712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655164800000",
    "number": "1770118911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8890",
            "fax_number": "303-952-0892"
        },
        {
            "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",
            "fax_number": "817-803-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTS AT CHISHOLM TRAIL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-09",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "JOYANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-803-4362",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentists at Chisholm Trail",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dentists at Chisholm Trail",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.