NPIMap

Organization Active NPI

GBCC Dental PLLC

  • Dentist
  • Fort Worth, TX
National Provider Identifier
1821475831
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
29154 Issued in TX
Legal business name
GBCC DENTAL PLLC
Practice address
6708 S Hulen
Ste. 3
Fort Worth, TX 76133
Phone
(817) 294-1090
Fax
(903) 465-1134
NPI assigned
Apr 28, 2015
Last updated
Sep 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Authorized official

Name
Dr. Clayton K Cook, DMDNPI 1578903217
Title
Owner/Dentist
Phone
(817) 294-1090

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
Dentist 122300000X 29154 TX Primary

Addresses

Primary practice location

6708 S Hulen
Ste. 3
Fort Worth, TX 76133

Mailing address

6708 S Hulen
Ste. 3
Fort Worth, TX 76133
Phone (817) 294-1090

Other names 1

  • Polished Family Dental Former legal business name

National Provider Directory

National Provider Directory

Locations

6708 S Hulen St
Fort Worth, TX 76133
Phone (817) 294-1090

6708 S Hulen St
Ste 3
Fort Worth, TX 76133
Phone (817) 294-1090

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": "1430179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632787200000",
    "number": "1821475831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6708 S HULEN",
            "address_2": "STE. 3",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76133",
            "telephone_number": "817-294-1090",
            "fax_number": "903-465-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6708 S HULEN",
            "address_2": "STE. 3",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76133",
            "telephone_number": "817-294-1090",
            "fax_number": "903-465-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GBCC DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "817-294-1090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "29154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Polished Family Dental",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Sep 28, 2021; 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.