Organization Active NPI

Island Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Mansfield, TX
National Provider Identifier
1770633257
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
12577 11979 12225 Issued in TX
Legal business name
ISLAND ORTHODONTICS
Practice address
800 Matlock Rd
Mansfield, TX 76063-9126
Phone
(817) 477-9283
Fax
(817) 453-5710
NPI assigned
Jan 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Sherri Smith
Title
Manager
Phone
(817) 477-9283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 12577 11979 12225 TX Primary

Addresses

Primary practice location

800 Matlock Rd
Mansfield, TX 76063-9126

Mailing address

800 Matlock Rd
Mansfield, TX 76063-9126
Phone (817) 477-9283

National Provider Directory

National Provider Directory

Locations

800 Matlock Rd
Mansfield, TX 76063
Phone (318) 347-0119

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770633257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MATLOCK RD",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760639126",
            "telephone_number": "817-477-9283",
            "fax_number": "817-453-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MATLOCK RD",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760639126",
            "telephone_number": "817-477-9283",
            "fax_number": "817-453-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "817-477-9283",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "12577 11979 12225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.