FOSSIL CREEK FAMILY DENTISTRY
NPI 1992249239
Dentist - General Practice in Ft Worth, TX
NPI Status: Active since December 06, 2016
Contact Information
6300 N. BEACH ST
FT WORTH, TX
ZIP 76137
Phone: (817) 281-3100
Fax: (817) 788-5984
- Organization
- Dentist
- General Practice
- CLIA Number: 45D0686536
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 07-06-2027
About FOSSIL CREEK FAMILY DENTISTRY
This page provides the complete NPI Profile along with additional information for Fossil Creek Family Dentistry, a provider established in Ft Worth, Texas operating as a Dentist, focusing in general practice . The healthcare provider is registered in the NPI registry with number 1992249239 assigned on December 2016. The practitioner's primary taxonomy code is 1223G0001X with license number 29655 (TX). The provider is registered as an organization and their NPI record was last updated 5 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Fossil Creek Family Dentistry. The authorized official of this NPI record is Mrs. Jamie E Gomez (Office Manager)
- NPI
- 1992249239
- Provider Legal Name
- TRACY KIRK DDS, PLLC
- Other Organization Name
- FOSSIL CREEK FAMILY DENTISTRY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 6300 N. BEACH ST FT WORTH, TX 76137
- Location Phone
- (817) 281-3100
- Location Fax
- (817) 788-5984
- Mailing Address
- 6300 N. BEACH ST HALTOM CITY, TX 76137
- Mailing Phone
- (817) 281-3100
- Mailing Fax
- (817) 788-5984
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-06-2016
- Last Update Date
- 10-20-2021
- Code Navigator
A dentist like Fossil Creek Family Dentistry is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist General Practice
- Taxonomy Code
- 1223G0001X
- Type
- Dental Providers
- License No.
- 29655
- License State
- TX
- Taxonomy Description
- 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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 45D0686536
- Facility Type
- Physician Office
- Certificate Effective Date
- July 07, 2025
- Certificate Expiration Date
- July 06, 2027
- Laboratory Director
- DAVID W. SIMONAK
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Fossil Creek Family Dentistry in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1992249239, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 71. The final step is to find the difference between that total and the next multiple of ten (80 - 71 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 71 is 80. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1992249239, enumerated as an "organization" on December 06, 2016.
The provider is located at 6300 N. BEACH ST FT WORTH, TX 76137 and the phone number is (817) 281-3100.
Dentist with taxonomy code 1223G0001X and a focus in General Practice.
