Individual provider Active NPI

Reza Naderi, D.M.D.

  • General Practice Dentistry
  • Plano, TX
National Provider Identifier
1114106150
Registry record updated Jun 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23740 Issued in TX
Practice address
1921 W 15TH Street
Suite 100
Plano, TX 75075-7311
Phone
(469) 573-3664
Fax
(469) 573-3664
NPI assigned
Oct 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 23740 TX Primary

Addresses

Primary practice location

1921 W 15TH Street
Suite 100
Plano, TX 75075-7311

Mailing address

1921 W 15TH Street
Suite 100
Plano, TX 75075-7311
Phone (469) 573-3664

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

Practice roles

OrganizationSpecialtyStatusNew patients
Zahn Dental, PLLC 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": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435104000000",
    "number": "1114106150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 W 15TH STREET",
            "address_2": "SUITE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750757311",
            "telephone_number": "469-573-3664",
            "fax_number": "469-573-3664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 W 15TH STREET",
            "address_2": "SUITE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750757311",
            "telephone_number": "469-573-3664",
            "fax_number": "469-573-3664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADERI",
        "first_name": "REZA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-26",
        "last_updated": "2015-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; 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.