Individual provider Active NPI

Keyvan Karimzadehnajjar, DDS

  • General Practice Dentistry
  • Allen, TX
National Provider Identifier
1225374127
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
28594 Issued in TX
Practice address
950 W Stacy Rd Ste 150
Allen, TX 75013-5125
Phone
(214) 260-9911
NPI assigned
Dec 20, 2012
Last updated
Jun 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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 28594 TX Primary

Addresses

Primary practice location

950 W Stacy Rd Ste 150
Allen, TX 75013-5125

Mailing address

950 W Stacy Rd Ste 150
Allen, TX 75013-5125
Phone (214) 260-9911

Other identifiers 1

IdentifierTypeStateIssuer
317066410MedicaidTX

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
28594TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dental Care General Practice 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1355961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1225374127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 W STACY RD STE 150",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750135125",
            "telephone_number": "214-260-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 W STACY RD STE 150",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750135125",
            "telephone_number": "214-260-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARIMZADEHNAJJAR",
        "first_name": "KEYVAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-20",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "28594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "317066410",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.