NPIMap

Organization Active NPI

Home Town Dental,PA

  • General Practice Dentistry
  • Lake Worth, TX
National Provider Identifier
1770790024
Registry record updated Sep 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15987 Issued in TX
Legal business name
HOME TOWN DENTAL,PA
Practice address
6332 Lake Worth Blvd
Lake Worth, TX 76135-3602
Phone
(817) 237-3222
NPI assigned
May 17, 2007
Last updated
Sep 12, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2007

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

Authorized official

Name
Dr. Monjit S Guram, DDS
Title
Owner
Phone
(817) 237-3222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 15987 TX Primary

Addresses

Primary practice location

6332 Lake Worth Blvd
Lake Worth, TX 76135-3602

Mailing address

6332 Lake Worth Blvd
Lake Worth, TX 76135-3602
Phone (817) 237-3222

National Provider Directory

National Provider Directory
Tax ID family
Home Town Dentalpa2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1770790024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6332 LAKE WORTH BLVD",
            "city": "LAKE WORTH",
            "state": "TX",
            "postal_code": "761353602",
            "telephone_number": "817-237-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6332 LAKE WORTH BLVD",
            "city": "LAKE WORTH",
            "state": "TX",
            "postal_code": "761353602",
            "telephone_number": "817-237-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME TOWN DENTAL,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "GURAM",
        "authorized_official_first_name": "MONJIT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-237-3222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "15987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; 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.