Individual provider Active NPI

Zohreh Khavandgar, DDS

  • Dentist
  • Fort Worth, TX
National Provider Identifier
1073176368
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
34770 Issued in TX
Practice address
5334 N Tarrant Pkwy
Fort Worth, TX 76244-6293
Phone
(817) 581-3411
NPI assigned
Apr 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 34770 TX Primary

Addresses

Primary practice location

5334 N Tarrant Pkwy
Fort Worth, TX 76244-6293

Mailing address

3083 Herschel Ave Apt 215
Dallas, TX 75219-2060
Phone (469) 781-7289

Other practice location 1

3083 Herschel Ave Apt 215
Dallas, TX 75219-2060
Phone (469) 781-7289

Other practice location 2

3083 Herschel Ave Apt 215
Dallas, TX 75219-2060
Phone (469) 781-7289

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
34770TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Worth Emergency Dental Care USA Management Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1073176368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3083 HERSCHEL AVE APT 215",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752192060",
            "telephone_number": "469-781-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5334 N TARRANT PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446293",
            "telephone_number": "817-581-3411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3083 Herschel Ave Apt 215",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752192060",
            "country_code": "US",
            "telephone_number": "469-781-7289",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3083 Herschel Ave Apt 215",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752192060",
            "country_code": "US",
            "telephone_number": "469-781-7289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAVANDGAR",
        "first_name": "ZOHREH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-22",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "34770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.