Dentists of Eagle Mountain, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DENTISTS OF EAGLE MOUNTAIN, PC

Practice address

4624 West Bailey Boswell Road
Suite 200
Fort Worth, TX 76179

Phone

(817) 203-1084

Fax

(817) 900-8066

NPI assigned

Jun 13, 2017

Organization subpart

No

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

Authorized official

Name

Dr. John S. Barnes

Title

DDS/Owner

Phone

(817) 203-1084

Specialties & licenses 1

Addresses

Other names 1

• Dentists of Eagle Mountain Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kanika S Daniel, DDS

  • General Practice Dentistry
  • Fort Worth, TX
  • NPI 1548594161
  NPD (past)

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649808000000",
    "number": "1912437922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4624 WEST BAILEY BOSWELL ROAD",
            "address_2": "SUITE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76179",
            "telephone_number": "817-203-1084",
            "fax_number": "817-900-8066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTS OF EAGLE MOUNTAIN, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-13",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "DDS/OWNER",
        "authorized_official_telephone_number": "817-203-1084",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentists of Eagle Mountain",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dentists of Eagle Mountain",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dental Republic- Seminary
• Dentistry for Children of Fort Worth PLLC
• Dentistry for Children PLLC
• Dentistry on Western Center
• Dentists at Chisholm Trail, PC
• Department of Veterans Affairs
• Thomas Elden Deporter, M.D.
• Depression Connection for Recovery
• Dept of Assistive & Rehab Serv - Fort Worth Field Headquarters
• Ivan Manuel Dequesada II, M.D.

• General Practice Dentistry in Fort Worth, TX
• Providers in Fort Worth, 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 Apr 13, 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.