Vivid Dentistry PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

VIVID DENTISTRY PLLC

Practice address

4541 Heritage Trace Pkwy Ste 1301
Fort Worth, TX 76244-8921

Phone

(912) 484-3405

NPI assigned

Feb 25, 2021

Organization subpart

No

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

Authorized official

Name

Trisha PatelNPI 1821576521

Title

Member

Phone

(912) 484-3405

Specialties & licenses 1

Addresses

Other names 1

• Vosh Dental 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.

• Trisha Patel, DDS

  • Dentist
  • Fort Worth, TX
  • NPI 1821576521
  NPD Authorized official

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

{
    "created_epoch": "1614211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614211200000",
    "number": "1992399422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2637 TOLEDO DR",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750624810",
            "telephone_number": "912-484-3405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4541 HERITAGE TRACE PKWY STE 1301",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448921",
            "telephone_number": "912-484-3405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVID DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-25",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "TRISHA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "912-484-3405"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vosh Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patricia Vitiello, CD, CPD, CBC, CBE
• Rodney D Vitovsky, PA-C
• Paola Isabella Vivar Andrade, RD LD
• Jennifer D Vivas
• Vivicare Health Partners, LLC
• Saranya Viyapon, DMD
• Angela Vizcaino, DPT
• Vma Partners LLC
• VMLC Grace Hulen, LLC
• VMLC Grace Hulen, LLC

• Dental Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.