NPIMap

Organization Active NPI

East Grand Family Dentistry, PLLC

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1154760247
Registry record updated Nov 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
25797 Issued in TX
Legal business name
EAST GRAND FAMILY DENTISTRY, PLLC
Practice address
5429 E Grand Ave
Dallas, TX 75223-1914
Phone
(214) 377-7312
Fax
(214) 377-7360
NPI assigned
Jun 21, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2013

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

Authorized official

Name
Dr. Shamim Moslemi, D.D.S.
Title
Owner
Phone
(972) 668-3003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 25797 TX Primary

Addresses

Primary practice location

5429 E Grand Ave
Dallas, TX 75223-1914

Mailing address

5429 E Grand Ave
Dallas, TX 75223-1914

Other names 1

  • East Dallas Family Dentistry Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1371772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384819200000",
    "number": "1154760247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5429 E GRAND AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752231914",
            "fax_number": "972-239-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5429 E GRAND AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752231914",
            "telephone_number": "214-377-7312",
            "fax_number": "214-377-7360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST GRAND FAMILY DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-21",
        "last_updated": "2013-11-19",
        "status": "A",
        "authorized_official_last_name": "MOSLEMI",
        "authorized_official_first_name": "SHAMIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-668-3003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Dallas Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2013; 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.