FORT WORTH CHILDRENS DENTISTRY NPI 1295046415

NPI Information

  • NPI: 1295046415
  • Provider Name: FORT WORTH CHILDRENS DENTISTRY
  • Classification: Dentist - 1223P0221X
  • Specialization: Pediatric Dentistry
  • Entity Type: Organization
  • CLIA Number: 45D2241413
  • Address: 4200 BRYANT IRVIN RD STE 129
    BENBROOK, TX
    ZIP 76109
  • Phone: (817) 569-6633

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NPI Details

FORT WORTH CHILDRENS DENTISTRY is a pediatric dentistry dentist in Benbrook, TX. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. FORT WORTH CHILDRENS DENTISTRY NPI is 1295046415. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

4200 BRYANT IRVIN RD STE 129
BENBROOK, TX
ZIP 76109-212
Phone: (817) 569-6633
Fax: (817) 569-6636

The provider's authorized official is Jack W Morrow .
The authorized official title is Dentist and has the following contact phone number (817) 569-6633.

The CLIA number assigned to this NPI record is 45D2241413 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/23/2010 and was last updated on 6/23/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0221XDentistPediatric DentistryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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