Organization Active NPI

Poorang Pahlavan DDS PLLC

  • General Practice Dentistry
  • Houston, TX
National Provider Identifier
1154888097
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
POORANG PAHLAVAN DDS PLLC
Practice address
10815 Veterans Memorial Dr Ste 1000
Houston, TX 77067-3888
Phone
(281) 529-6266
Fax
(281) 529-6267
NPI assigned
Feb 27, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2019

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

Authorized official

Name
Poorang Pahlavan, DDS
Title
Owner
Phone
(281) 529-6266

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

10815 Veterans Memorial Dr Ste 1000
Houston, TX 77067-3888

Mailing address

10815 Veterans Memorial Dr Ste 1000
Houston, TX 77067-3888
Phone (281) 529-6266

Other identifiers 1

IdentifierTypeStateIssuer
1350738MedicaidTX

Other names 1

  • Smile Barn Dental Doing business as

National Provider Directory

National Provider Directory

Locations

10815 Veterans Memorial Dr
Ste 1000
Houston, TX 77067
Phone (281) 529-6266

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551225600000",
    "number": "1154888097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10815 VETERANS MEMORIAL DR STE 1000",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770673888",
            "telephone_number": "281-529-6266",
            "fax_number": "281-529-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10815 VETERANS MEMORIAL DR STE 1000",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770673888",
            "telephone_number": "281-529-6266",
            "fax_number": "281-529-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POORANG PAHLAVAN DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-27",
        "last_updated": "2019-02-27",
        "status": "A",
        "authorized_official_last_name": "PAHLAVAN",
        "authorized_official_first_name": "POORANG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-529-6266",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1350738",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Barn Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.