Idental

Primary specialty

DentistTaxonomy code 122300000X

License

19711 Issued in TX

Legal business name

IDENTAL

Practice address

14902 Preston Rd Ste 401
Dallas, TX 75254-9132

Phone

(916) 425-4172

NPI assigned

Feb 2, 2017

Last updated

Feb 2, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hossain Dezham, DDS

Title

Dentist

Phone

(916) 425-4172

Specialties & licenses 1

Addresses

Tax ID family

Idental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Idental

  • Dentist
  • Dallas, TX
  • NPI 1265830947
  NPD tax ID

Locations

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485993600000",
    "number": "1245778935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14902 PRESTON RD STE 401",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752549132",
            "telephone_number": "916-425-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14902 PRESTON RD STE 401",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752549132",
            "telephone_number": "916-425-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-02",
        "last_updated": "2017-02-02",
        "status": "A",
        "authorized_official_last_name": "DEZHAM",
        "authorized_official_first_name": "HOSSAIN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "916-425-4172",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "19711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ideal Dental of Uptown
• Ideal Dental of Valley Ranch PLLC
• Ideal Home Health, Inc
• Ideal Physical Therapy of Texas LLC
• Idell Psychiatry
• Idental
• Audrey Idom
• Ahamed H Idris, MD
• Javairia Idris
• Azra Idrizovic, D.O.

• Dentist in Dallas, TX
• Providers in Dallas, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; 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.