DR. ROBERT TRUITT MABERRY, JR. (NPI# 1609846617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609846617 |
| Entity Type | Individual |
| Full Name | DR. ROBERT TRUITT MABERRY, JR. |
| Credential | DDS |
| Practice Address |
3980 Boat Club Rd. Ste. 114 Ft. Worth TX 76135 |
| Mailing Address |
3980 Boat Club Rd. #114 Ft. Worth TX 76135 |
| Practice Telephone | 8172371600 |
| Practice Fax Number | 8172372604 |
| Mailing Telephone | 8172371600 |
| Mailing Fax Number | 8172372604 |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
10721 | TX | Dental Providers |
| Street Address |
3980 BOAT CLUB RD. STE. 114 |
| City | FT. WORTH |
| State | TX |
| Zip Code | 76135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992283501 | Sung Ryel Choi | Dentist | 6014 Azle Ave # 100, Lake Worth, TX 76135 | 2018-08-06 |
| 1750882056 | Kandess Klein | Licensed Vocational Nurse | 8825 Claiborn St, Lakeside, TX 76135 | 2018-02-22 |
| 1841791258 | Robyn Rich | Technician | 5104 Prestwick Drive, Fort Worth, TX 76135 | 2018-02-22 |
| 1598207821 | Young Men's Christian Association of Metropolitan Fort Worth | Health Educator | 5315 Boat Club Rd, Fort Worth, TX 76135 | 2016-11-17 |
| 1558818534 | Clearfork Academy Lp | Substance Abuse Rehabilitation Facility | 7820 Hanger Cut Off, Fort Worth, TX 76135 | 2016-09-07 |
| 1316300999 | National Vision, Inc. | Technician/Technologist | 6014 Azle Ave, Ste 200, Lake Worth, TX 76135 | 2016-04-01 |
| 1457647570 | Cynthia Rosaline Witt | Optometrist | 6014 Azle Avenue, Suite 300, Lake Worth, TX 76135 | 2011-06-27 |
| 1316134125 | Home Town Dental,pa | Dentist | 6332 Lake Worth, Lake Worth, TN 76135 | 2007-09-26 |
| 1790984789 | Jonathan Nicholas Valamides | Optometrist | 6060 Azle Ave. Suite 500, Lake Worth, TX 76135 | 2007-07-11 |
| 1457570053 | Dawn Denise Ezelle | Occupational Therapy Assistant | 3400 Marine Drive, Fort Worth, TX 76135 | 2007-04-24 |
| Find all providers in zip 76135 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881014512 | Amos Ben Ross | Dentist | 4760 Barwick, Dr, Suite B, Ft. Worth, TX 76132 | 2014-04-21 |
| 1295011369 | Marvin Eugene Williams | Dentist | 3913 E. Lancaster, Ft. Worth, TX 76103 | 2011-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447537 | Azle Cube Smiles Pllc | Dentist | 100 Park Plc Ste 224, Azle, TX 76020 | 2020-11-04 |
| 1548860257 | Emeka Abazie Dds Pa | Dentist | 1001 N. Beckley, Suite 304, Desoto, TX 75115 | 2020-10-30 |
| 1699375543 | Long Family Dental | Dentist | 4470 E Highway 287 Ste 1200, Midlothian, TX 76065-7556 | 2020-10-29 |
| 1548860992 | Vequinox Pllc | Dentist | 2605 N Shary Rd, Mission, TX 78574-3221 | 2020-10-27 |
| 1952900466 | Gwendolyn Kines-mcleod Dds,pllc | Dentist | 401 N Ann St Ste B, Terrell, TX 75160-2549 | 2020-10-26 |
| 1609476183 | Texas Saas Pa | Dentist | 3839 Mckinney Ave Ste 130, Dallas, TX 75204-1489 | 2020-10-26 |
| 1295334803 | Jpm Dental of Spring | Dentist | 7312 Louetta Rd Ste B119, Spring, TX 77379-6176 | 2020-10-23 |
| 1750980025 | Neda Hani Tabaei Zavareh | Dentist | 10900 Twisted Elm Dr, Austin, TX 78726-2369 | 2020-10-19 |
| 1710586029 | Whitestone Dental Center Pllc | Dentist | 500 W Whitestone Blvd Ste 102, Cedar Park, TX 78613-2271 | 2020-10-19 |
| 1841899226 | Calvin Eastwood Dds Pllc | Dentist | 3088 Basswood Blvd # 150, Fort Worth, TX 76137-1676 | 2020-10-18 |
| Find all providers with the same taxonomy | ||||
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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.