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Deactivated NPI 1740378413 Deactivated / Inactive NPI Male Practitioner

Dr. Mark Steven De Anda , DDS

Dentist • Fort Worth, TX

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Mark De Anda has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 10, 2006
NPI Deactivation Date February 01, 2023
Total Practice Duration ~17 Years of Practice (2006 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Mark De Anda, DDS was a registered Dentist practicing in Fort Worth, TX. Throughout an active medical career spanning 17 years, Dr. De Anda provided care at the practice location at 300 W ROSEDALE ST until profile deactivation on 2023-02-01.

Practice Location & Contact Primary Location

Practice Address

300 W Rosedale St

Fort Worth, TX 761044856

Telephone 8178826025
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Fort Worth, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.7 Yrs
Regional Practice Density
157 Specialists

Practicing in Fort Worth, TX (6851 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License TX 16490

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

19 Associated Practitioners
Dr. Teresa Lugo , MD

Internal Medicine

NPI 1114029964

Doctor of Medicine (M.D.)

Clyde Hartman , PA

Physician Assistant

NPI 1154371771

Physician Assistant

NPI 1194792788

Doctor of Medicine (M.D.), Master of Public Health

NPI 1194823088

Registered Pharmacist

NPI 1194881458

Registered Pharmacist

NPI 1225144611

Doctor of Dental Medicine, Master of Public Health

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

15 Historical Events
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NPI Profile Deactivated February 01, 2023

Record deactivated on February 01, 2023

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Updated Practice Location August 15, 2018

Registered at 1415 CALIFORNIA ST, HOUSTON, TX 77006 (Tel: 8325485000)

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 15, 2018

Dentist (License #16490 in TX)

NPI Profile Active February 15, 2017

NPI status registered as active in NPPES database

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Updated Practice Location February 15, 2017

Registered at 1415 CALIFORNIA ST, HOUSTON, TX 770062602 (Tel: 8325485000)

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Updated Business Mailing Address February 15, 2017

Registered at PO BOX 66308, HOUSTON, TX 772666308

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Provider Name / Credentials Updated February 15, 2017

Recorded as MARK DE ANDA, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 15, 2017

Dentist (License #16490 in TX)

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Updated Business Mailing Address January 25, 2017

Registered at 1105 AUTUMN MIST WAY, ARLINGTON, TX 760054503 (Tel: 2817822134)

NPI Profile Active June 02, 2008

NPI status registered as active in NPPES database

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Updated Practice Location June 02, 2008

Registered at 300 W ROSEDALE ST, FORT WORTH, TX 761044856 (Tel: 8178826025)

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Updated Business Mailing Address June 02, 2008

Registered at 1450 N STATE HIGHWAY 360, #390, GRAND PRAIRIE, TX 750502590 (Tel: 2817822134)

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Provider Name / Credentials Updated June 02, 2008

Recorded as MARK DE ANDA, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 02, 2008

Dentist (License #16490 in TX)

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Initial NPI Registration & Enumeration October 10, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1740378413
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 10, 2006
Last Update: June 02, 2008
Deactivation Date: February 01, 2023

Mailing Address

1450 N State Highway 360, #390

Grand Prairie, TX 750502590

Phone: 2817822134

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.