VIVID DENTISTRY PLLC NPI 1992399422

NPI Information

NPI: 1992399422
Provider Name: VIVID DENTISTRY PLLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
4541 HERITAGE TRACE PKWY STE 1301
FORT WORTH, TX
ZIP 76244
Phone: (912) 484-3405
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VIVID DENTISTRY PLLC is a dental clinic center in Fort Worth, TX. VIVID DENTISTRY PLLC NPI is 1992399422. The provider is registered as an organization entity type.

The provider's business location address is:

4541 HERITAGE TRACE PKWY STE 1301
FORT WORTH, TX
ZIP 76244-921
Phone: (912) 484-3405

The provider's authorized official is Trisha Patel .
The authorized official title is Member and has the following contact phone number (912) 484-3405.

The enumeration date for this NPI number is 2/25/2021 and was last updated on 2/25/2021.

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
1	261QD0000X	Clinic/Center	Dental			Yes

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: 11/14/2023

NPI Synchronization or Removal

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