Lake Country Dental

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

LAKE COUNTRY DENTAL

Practice address

8461 Boat Club Rd
Fort Worth, TX 76179-3607

Phone

(817) 236-8771

Fax

(817) 236-8791

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ray D. Snider, D.D.S., P.A.NPI 1083703672

Title

Owner/Dentist

Phone

(817) 236-8771

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Ray D Snider, D.D.S., P.A.

  • General Practice Dentistry
  • Fort Worth, TX
  • NPI 1083703672
  NPD (past) Authorized official

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972692556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8461 BOAT CLUB RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761793607",
            "telephone_number": "817-236-8771",
            "fax_number": "817-236-8791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8461 BOAT CLUB RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761793607",
            "telephone_number": "817-236-8771",
            "fax_number": "817-236-8791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE COUNTRY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SNIDER",
        "authorized_official_first_name": "RAY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "817-236-8771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., P.A."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA #",
            "identifier": "841904",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER #",
            "identifier": "D12073",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trung Lai
• Tanya Denise Laib-Shipley, AGACNP
• Brook Pritchard Laird, CRNA
• Stephanie Laird, PT, DPT
• Elizabeth Lakamp
• Lake Country Family Medicine, P.a.
• Lake Family and Cosmetic Dentistry
• Lake Worth Center Dental PLLC
• Lake Worth Counseling
• Lake Worth Independent School District

• Dentist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.