Active NPI
David C Medford, DDS
- General Practice Dentistry
- Fort Worth, TX
National Provider Identifier
1992911861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 13112
- Practice address
- 6320 Southwest Blvd. Ste 112
Fort Worth, TX 76109 - Phone
- (817) 923-9877
- Fax
- (817) 923-9854
- NPI assigned
- May 15, 2007
- Last updated
- Aug 23, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 13112 | TX | Primary |
Addresses
Primary practice location
6320 Southwest Blvd. Ste 112
Fort Worth, TX 76109
Mailing address
6320 Southwest Blvd. Ste 112
Fort Worth, TX 76109
Phone (817) 923-9877
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Matthew R Bentley DMD PC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629676800000",
"number": "1992911861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6320 SOUTHWEST BLVD. STE 112",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "76109",
"telephone_number": "817-923-9877",
"fax_number": "817-923-9854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6320 SOUTHWEST BLVD. STE 112",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "76109",
"telephone_number": "817-923-9877",
"fax_number": "817-923-9854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDFORD",
"first_name": "DAVID",
"middle_name": "C",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-15",
"last_updated": "2021-08-23",
"certification_date": "2021-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "13112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
- Elizabeth Irene Mederos, LMSW
- Gerardo Mederos, MD
- Medexpress Urgent Care Texas, P.a. (MedExpress Urgent Care - Fort Worth, S Hulen St)
- Medexpress Urgent Care Texas, P.a. (MedExpress Urgent Care - Keller, N Tarrant Pkwy)
- Ashley Lowe Medford, NP
- Joanne Medford, PTA
- Medfund LLC (Horizon Fort Worth LLC)
- Medhealth Center Inc
- Medica-Rents Co LLC
- Medica-Rents Co., LTD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.