Provider Demographics
NPI:1942394150
Name:AINSWORTH, JOSEPH C III (DDS MSD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:C
Last Name:AINSWORTH
Suffix:III
Gender:M
Credentials:DDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 N OCONNOR RD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-5650
Mailing Address - Country:US
Mailing Address - Phone:972-255-0544
Mailing Address - Fax:972-255-7403
Practice Address - Street 1:2727 N OCONNOR RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-5650
Practice Address - Country:US
Practice Address - Phone:972-255-0544
Practice Address - Fax:972-255-7403
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81491223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170131001Medicaid