TIMBER CREEK ORTHODONTICS, P.A. (NPI# 1063798718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063798718 |
| Entity Type | Organization |
| Organization Name | TIMBER CREEK ORTHODONTICS, P.A. |
| Practice Address |
12650 N Beach St Suite 100 Fort Worth TX 76244-4243 |
| Practice Telephone | 8175623292 |
| Mailing Telephone | 8175623292 |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2011-10-26 |
| Authorized Official Name | DANIEL C MALLORY (ORTHODONTIST) |
| Authorized Official Telephone | 8175623292 |
| Authorized Official Credential | D.D.S., M.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
20625 | TX | Dental Providers |
| Street Address |
12650 N BEACH ST SUITE 100 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76244-4243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396387189 | Lauren A. Roth | Behavior Technician | 12650 N Beach St, Fort Worth, TX 76244-4243 | 2019-10-13 |
| 1437684354 | Timber Creek Dental & Orthodontics | Dentist | 12650 N Beach St, Suite 100, Fort Worth, TX 76244-4243 | 2017-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538773510 | Aum Nitin Patel | Optometrist | 12584 N Beach Street #122, Keller, TX 76244 | 2020-09-07 |
| 1477178374 | Trinity Spine and Orthopedics, Pllc | Orthopaedic Surgery | 4444 Heritage Trace, Suite 408, Keller, TX 76244 | 2020-06-16 |
| 1235778622 | Hope Family Healthcare LLC | Nurse Practitioner | 4610 Heritage Trace Pkwy, Ste 400, Keller, TX 76244 | 2020-01-02 |
| 1104468917 | Kylie Ann Montgomery | Behavior Technician | 12650 N Beach St Suite 146, Fort Worth, TX 76244 | 2019-10-14 |
| 1376193433 | Ntkc - Dfw, Pllc | Internal Medicine | 10700 Victoria Ash Dr., Keller, TX 76244 | 2019-09-19 |
| 1629628532 | Today Dental of Saginaw Pllc | Dentist | 1628 Basswood Blvd, Fort Worth, TX 76244 | 2019-09-13 |
| 1962050492 | Precision Ambulatory Surgery Center, LLC | Ophthalmology | 9439 North Beach Street, Fort Worth, TX 76244 | 2019-08-28 |
| 1770145351 | Texas Health Spine Surgery Center Alliance LLC | Clinic/Center | 10900 Founders Way, Suite 100, Fort Worth, TX 76244 | 2019-07-03 |
| 1770048720 | Robin Jansen | Occupational Therapy Assistant | 4317 Oak Chase Dr, Keller, TX 76244 | 2019-02-04 |
| 1033687256 | Marian Abibatu James | Nurse Practitioner | 4516 Jaylin St, Keller, TX 76244 | 2018-11-06 |
| Find all providers in zip 76244 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154928943 | Amanda Gerlach | Dentist | 3550 Hulen St Ste C, Fort Worth, TX 76107-6885 | 2020-10-05 |
| 1447898093 | Evan Perkins | Dentist | 4763 Barwick Dr Ste 107, Fort Worth, TX 76132-1531 | 2019-12-13 |
| 1578060943 | Irish Abigail Martinez Tongco | Dentist | 3201 Western Center Blvd Ste 115, Fort Worth, TX 76137-7135 | 2018-04-11 |
| 1306227731 | Lustig and Young Orthodontics | Dentist | 8450 Park Vista Blvd, Fort Worth, TX 76137-5731 | 2015-06-11 |
| 1588087027 | Nicole Mahoney | Dentist | 9040 Hawley Dr, Fort Worth, TX 76244-6120 | 2014-02-03 |
| 1841545597 | Braces R Us PC | Dentist | 8337 Summer Park Dr, Fort Worth, TX 76123-1991 | 2012-07-18 |
| 1134449663 | Access Orthodontics of Berry, P.a. | Dentist | 4201 E Berry St, Suite #15, Fort Worth, TX 76105-5053 | 2010-06-07 |
| 1528211406 | Jacksboro Smiles By Wire, Pllc | Dentist | 2480 Jacksboro Hwy, Fort Worth, TX 76114-2201 | 2008-10-23 |
| 1366605719 | William G Paulus Dds Ms Inc | Dentist | 4901 Byers Ave, Fort Worth, TX 76107 | 2008-07-07 |
| 1801079124 | Ciro Cabal | Dentist | 5800 Boat Club Rd, Fort Worth, TX 76179-7773 | 2007-12-10 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76244 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.