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TRACY KIRK DDS PLLC NPI 1992249239


NPI Information

NPI: 1992249239
Provider Name: TRACY KIRK DDS, PLLC

Doing Business As: FOSSIL CREEK FAMILY DENTISTRY

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 45D0686536

Address:
6300 N. BEACH ST
FT WORTH, TX
ZIP 76137
Phone: (817) 281-3100
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TRACY KIRK DDS, PLLC is a general practice dentist in Ft Worth, TX. The provider is 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. TRACY KIRK DDS, PLLC NPI is 1992249239. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Fossil Creek Family Dentistry.

The provider's business location address is:

6300 N. BEACH ST
FT WORTH, TX
ZIP 76137
Phone: (817) 281-3100
Fax: (817) 788-5984

The provider's authorized official is Jamie E Gomez .
The authorized official title is Office Manager and has the following contact phone number (817) 281-3100.

The CLIA number assigned to this NPI record is 45D0686536 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 12/6/2016 and was last updated on 10/20/2021.


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
11223G0001XDentistGeneral Practice29655TEXASYes

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: 5/5/2024

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