Primrose Dental Group, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PRIMROSE DENTAL GROUP, PLLC

Practice address

3522 Denton Hwy
Haltom City, TX 76117-3210

Phone

(817) 918-4470

NPI assigned

Sep 23, 2026

Organization subpart

No

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

Authorized official

Name

Jackson Fuller, DDS

Title

Owner

Phone

(208) 206-9375

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1790121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790121600000",
    "number": "1831002724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 VILLAGE PKWY STE 120",
            "city": "HIGHLAND VILLAGE",
            "state": "TX",
            "postal_code": "750773285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3522 DENTON HWY",
            "city": "HALTOM CITY",
            "state": "TX",
            "postal_code": "761173210",
            "telephone_number": "817-918-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMROSE DENTAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-23",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "JACKSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-206-9375",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chuong Van Pham, D.C.
• Donna Duyen Pham
• Tiana Hoang Thy Pham, D.D.S.
• Kristen R. Potts, RDH
• Jalyssia D Powell, LVN
• Primrose Dental PLLC
• Kristin Pustejovsky, M.S., CCC-SLP
• Andrea Quigley, LPN
• Natasha Mathew Raju
• Jordan Celeste Ramirez, RD, LD

• General Practice Dentistry in Haltom City, TX
• Providers in Haltom City, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.