Organization Active NPI

Members Only Dental PA

Doing business as Bella Vita Dentistry

  • General Practice Dentistry
  • Trophy Club, TX
National Provider Identifier
1811376387
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23918 Issued in TX
Legal business name
MEMBERS ONLY DENTAL PA
Doing business as
Bella Vita Dentistry
Practice address
925 Trophy Club Dr
Trophy Club, TX 76262-5582
Phone
(817) 345-6960
NPI assigned
May 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2015

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

Authorized official

Name
Dr. Joshua Foreman Sr., DDSNPI 1336310911
Title
President
Phone
(817) 345-6960

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 23918 TX Primary

Addresses

Primary practice location

925 Trophy Club Dr
Trophy Club, TX 76262-5582

Mailing address

925 Trophy Club Dr
Trophy Club, TX 76262-5582
Phone (817) 345-6960

Other names 1

  • Bella Vita Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

925 Trophy Club Dr
Trophy Club, TX 76262
Phone (817) 345-6960

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": "1432857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432857600000",
    "number": "1811376387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 TROPHY CLUB DR",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "762625582",
            "telephone_number": "817-345-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 TROPHY CLUB DR",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "762625582",
            "telephone_number": "817-345-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMBERS ONLY DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-29",
        "last_updated": "2015-05-29",
        "status": "A",
        "authorized_official_last_name": "FOREMAN",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-345-6960",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bella Vita Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Trophy Club, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; 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.