NPIMap

Organization Active NPI

Lifetime and Cosmetic Dentistry

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1841521879
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21381 Issued in TX
Legal business name
LIFETIME AND COSMETIC DENTISTRY
Practice address
5040 N Tarrant Pkwy
Suite 118
Fort Worth, TX 76244-5389
Phone
(817) 750-5433
Fax
(817) 750-5431
NPI assigned
Jan 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Authorized official

Name
Dr. Sonya Austin
Title
Owner
Phone
(817) 750-5433

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 21381 TX Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 21561 TX

Addresses

Primary practice location

5040 N Tarrant Pkwy
Suite 118
Fort Worth, TX 76244-5389

Mailing address

5040 N Tarrant Pkwy
Suite 118
Fort Worth, TX 76244-5389
Phone (817) 750-5433

Other identifiers 2

IdentifierTypeStateIssuer
21561OtherTX1223G0001X-DENTIST-GENERAL PRACTICE
21381OtherTX1223G0001X-DENTIST-GENERAL PRACTISE

National Provider Directory

National Provider Directory

Locations

5040 North Tarrant Pkwy
Ste 118
Fort Worth, TX 76244
Phone (817) 750-5433

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": "1263427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263427200000",
    "number": "1841521879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5040 N TARRANT PKWY",
            "address_2": "SUITE 118",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445389",
            "telephone_number": "817-750-5433",
            "fax_number": "817-750-5431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5040 N TARRANT PKWY",
            "address_2": "SUITE 118",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445389",
            "telephone_number": "817-750-5433",
            "fax_number": "817-750-5431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME AND COSMETIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-14",
        "last_updated": "2010-01-14",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "SONYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-750-5433",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21381",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21561",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1223G0001X-DENTIST-GENERAL PRACTICE",
            "identifier": "21561",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1223G0001X-DENTIST-GENERAL PRACTISE",
            "identifier": "21381",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jan 14, 2010; 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.