Individual provider Active NPI

Laura Wasek-Throm, DMD,MPH

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1881144236
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
35880 Issued in TX
Practice address
5720 Locke Ave
Fort Worth, TX 76107-5020
Phone
(817) 737-6601
NPI assigned
Oct 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901021520 MI
General Practice Dentistry 1223G0001X 35880 TX Primary

Addresses

Primary practice location

5720 Locke Ave
Fort Worth, TX 76107-5020

Mailing address

4225 Ranier CT
Fort Worth, TX 76109-5028
Phone (231) 392-3553

Other practice location 1

200 Turwill Ln
Kalamazoo, MI 49006-4277
Phone (269) 344-9006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2901021520MIMDGeneral Practice Dentistry
35880TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Worth Cosmetic & Family Dentistry General Practice PastSince Oct 23, 2022 Accepting new patients
Carrie Lintner DDS PLC General Practice Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1881144236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 RANIER CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761095028",
            "telephone_number": "231-392-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5720 LOCKE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761075020",
            "telephone_number": "817-737-6601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Turwill Ln",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490064277",
            "country_code": "US",
            "telephone_number": "269-344-9006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASEK-THROM",
        "first_name": "LAURA",
        "credential": "DMD,MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-10",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901021520",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "35880",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 18, 2022; 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.