1730587304 NPI number — FORT WORTH EMERGENCY DENTAL CARE USA MANAGEMENT INC.

Table of content: DR. ALAN J. SCHECTER M.D. (NPI 1407895774)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730587304 NPI number — FORT WORTH EMERGENCY DENTAL CARE USA MANAGEMENT INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FORT WORTH EMERGENCY DENTAL CARE USA MANAGEMENT INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730587304
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/15/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4245 S 143RD CIR
Provider Second Line Business Mailing Address:
SUITE 7
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68137-4516
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-393-2726
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5334 N TARRANT PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT WORTH
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76244-6293
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-581-3411
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/15/2014

Additional Information

Authorized Official

Authorized Official Last Name:
OBENG
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
402-393-2726

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com