DR. LACEDRIC REITRICH TOLLIVER (NPI# 1972817948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972817948 |
| Entity Type | Individual |
| Full Name | DR. LACEDRIC REITRICH TOLLIVER |
| Credential | D.M.D. |
| Practice Address |
1501 Handley Dr Fort Worth TX 76112-3328 |
| Mailing Address |
2502 Riverside Pkwy Apt 1324 Grand Prairie TX 75050-7969 |
| Practice Telephone | 8174574141 |
| Mailing Telephone | 6177174487 |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2010-08-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 25725 | TX | Dental Providers |
| Street Address |
1501 HANDLEY DR |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76112-3328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033133699 | Andy Chi Chang | Dentist | 1501 Handley Dr, Fort Worth, TX 76112-3328 | 2006-07-27 |
| 1548495443 | Western Dental | Dentist | 1501 Handley Dr, Fort Worth, TX 76112 | 2009-05-20 |
| 1972711794 | Elite Dental Group, Pa | Dentist | 1501 Handley Dr, Fort Worth, TX 76112-3328 | 2007-05-18 |
| 1427072099 | Brian Ashley Alford | Dentist | 1501 Handley Dr, Fort Worth, TX 76112-3328 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396211397 | Shelia Minor | Home Health Aide | 5648 Victoria Place, Fort Worth, TX 76112 | 2018-10-17 |
| 1457833816 | Joanne Medford | Physical Therapy Assistant | 1704 Wilson Rd, Fort Worth, TX 76112 | 2018-09-02 |
| 1821525502 | Kids & Hugs Home Therapy | Home Health | 2317 Maryel Dr., Fort Worth, TX 76112 | 2017-05-12 |
| 1932516846 | Neuroassessment Services LLC | Clinical Neuropsychologist | 5601 Bridge Street, Suite 500, Ft. Worth, TX 76112 | 2014-07-14 |
| 1114346335 | Blessed Beginnings | Day Training, Developmentally Disabled Services | 2320 Blue Smoke Court North, Fort Worth, TX 76112 | 2014-04-15 |
| 1790035517 | Transitions for Success Inc | In Home Supportive Care | 6228 Warrington Pl Ace, Fort Worth, TX 76112 | 2012-09-19 |
| 1194048116 | Jerlene Bonner Tippett | Home Health Aide | 1701 Bunch Dr, Ft Worth, TX 76112 | 2010-03-04 |
| 1396076543 | Roy Kenji Yamada | Emergency Medicine | 5800 Forest Bend Pl., Ft. Worth, TX 76112 | 2010-01-27 |
| 1437488228 | Rose A Miller | Case Manager/Care Coordinator | 7312 Laurie Drive, Ft. Worth, TX 76112 | 2009-12-08 |
| 1174760508 | Advocate Angels | Case Management | 6829 Gary Lane, Fort Worth, TX 76112 | 2009-01-07 |
| Find all providers in zip 76112 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497354179 | Perla Dental of Keller Pa | Dentist | 5325 Golden Triangle Blvd Ste 100, Fort Worth, TX 76244-4469 | 2020-10-22 |
| 1962028514 | Christopher Thomas Mathew | Dentist | 4744 Bryant Irvin Rd, Fort Worth, TX 76132-3646 | 2020-06-19 |
| 1376016469 | Brident Dental Associates PC | Dentist | 815 E Berry St Ste B, Fort Worth, TX 76110-4457 | 2019-01-10 |
| 1972089241 | Hulen Dental Partners Pplc | Dentist | 6217 Oakmont Blvd, Fort Worth, TX 76132-2812 | 2018-07-19 |
| 1811473499 | Oak View Family Dentistry Pllc | Dentist | 8201 N. Beach St. Unit 101, Fort Worth, TX 76244 | 2018-07-17 |
| 1184118465 | Lisa Tran | Dentist | 515 W Loop 820 N Ste 101, Fort Worth, TX 76108-1450 | 2018-06-19 |
| 1548772213 | Ideal Dental of West 7th Pllc | Dentist | 628 Harrold St Ste 124, Fort Worth, TX 76107-2323 | 2017-11-02 |
| 1396269429 | Matthew Pedroza | Dentist | 4625 Feathercrest Dr., Fort Worth, TX 76137 | 2017-07-31 |
| 1083138341 | Shakti Darshan Pllc | Dentist | 10313 Roatan Trl, Fort Worth, TX 76244-2039 | 2017-07-28 |
| 1336662022 | Ben Luka | Dentist | 639 Alta Mere Dr, Fort Worth, TX 76114 | 2017-07-25 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76112 |
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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.