DR. KEITH SONNEVELD (NPI# 1386058584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386058584 |
| Entity Type | Individual |
| Full Name | DR. KEITH SONNEVELD |
| Credential | DDS |
| Practice Address |
4421 Oak Park Ln Ste 101 Fort Worth TX 76109-9541 |
| Practice Telephone | 8179271818 |
| Mailing Telephone | 8179271818 |
| Mailing Fax Number | 8179272351 |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2020-08-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
33281 | TX | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DN015732 | GA | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11975 Morris Rd Ste 220, Alpharetta, GA 300054444 | 6786910880 | |
| 1500 S Main St, Fort Worth, TX 761044917 | 8179206936 | |
| 1880 W Oak Pkwy Ste 111, Marietta, GA 30062 | 6789059066 |
| Street Address |
4421 OAK PARK LN STE 101 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76109-9541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720690100 | Facial and Cosmetic Surgery of Fort Worth | Dentist | 4421 Oak Park Ln Ste 101, Fort Worth, TX 76109-9541 | 2020-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881156164 | Elizabeth Laborde Dds Pllc | Clinic/Center | 5656 Edwards Ranch Rd, Fort Worth, TX 76109 | 2019-04-04 |
| 1992273965 | Debra Cooper Lantz | Occupational Therapist | 4252 Bryant Irvin Road, Fort Worth, TX 76109 | 2018-11-08 |
| 1417434119 | Dermatology Specialists of Fort Worth Pllc | Dermatology | 6100 Southwest Blvd., Suite 100, Fort Worth, TX 76109 | 2018-07-25 |
| 1417446709 | Eating Recovery Center of Texas, LLC | Clinic/Center | 4200 S. Hulen Street, Suite #436, Ft. Worth, TX 76109 | 2018-05-02 |
| 1245751742 | Marissa Izabel San Miguel | Optometrist | 5912 Convair Dr Ste 208, Fort Worth, TX 76109 | 2017-07-05 |
| 1174910111 | Parkway Dental Professionals | Preferred Provider Organization | 4200 Bryant Irvin Rd. Ste. 101, Fort Worth, TX 76109 | 2015-04-16 |
| 1831583095 | Deborah K Lehmann, M.d. | Clinic/Center | 6420 Southwest Blvd., #128, Fort Worth, TX 76109 | 2015-03-26 |
| 1184036428 | Ft Worth Ranch Assist, LLC | Neurological Surgery | 3516 Ranch View Terrace, Fort Worth, TX 76109 | 2014-05-21 |
| 1821435538 | Metx LLC | Hearing Instrument Specialist | 4618 Sw Loop 820, Fort Worth, TX 76109 | 2013-06-04 |
| 1356608087 | Virginia Flores | Social Worker | 4208 Ranier Ct, Fort Worth, TX 76109 | 2012-04-19 |
| Find all providers in zip 76109 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720337 | Texas Wisdom Teeth Specialists | Dentist | 8409 W Cleburne Rd, Fort Worth, TX 76123-1421 | 2020-11-04 |
| 1699155507 | Implants and Oral Surgery, PC | Dentist | 7217 Hawkins View Dr Ste 200, Fort Worth, TX 76132-3928 | 2015-06-05 |
| 1598968190 | Herman Kao | Dentist | 1625 Saint Louis Ave., Fort Worth, TX 76104 | 2007-06-09 |
| 1215130810 | Fayette Creed Williams | Dentist | 1625 Saint Louis Avenue, House Staff & Gme, Fort Worth, TX 76104 | 2007-06-09 |
| 1235353301 | Robert Peak | Dentist | 900 Jerome St, Suite 140, Fort Worth, TX 76104-3945 | 2007-04-12 |
| 1972614071 | Spielman Peak Lois & Humes Dds Ms Inc. | Dentist | 7217 Hawkins View Dr, Suite 200, Fort Worth, TX 76132-3927 | 2006-08-31 |
| 1225070030 | Gregory Blaine Scheideman | Dentist | 4300 Oak Park Ln, Fort Worth, TX 76109-1512 | 2006-06-13 |
| 1508805516 | Joseph Carl Cecere | Dentist | 2501 Ridgmar Plz, Suite 108, Fort Worth, TX 76116-2689 | 2006-06-05 |
| 1538156658 | Max Gregory Neill | Dentist | 4421 Oak Park Ln, Ste 101, Fort Worth, TX 76109-9541 | 2005-10-04 |
| 1356334502 | David Edward Parmer | Dentist | 9415 N Beach St, Fort Worth, TX 76244-9059 | 2005-08-23 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76109 |
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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.