Individual provider Active NPI

Talin Mirzoyan Kalach, DDS

  • Periodontics
  • Katy, TX
National Provider Identifier
1285357624
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
39072 Issued in TX
Practice address
24437 Katy Fwy Ste 500
Katy, TX 77494-1469
Phone
(281) 394-9340
NPI assigned
Sep 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 39072 TX Primary

Addresses

Primary practice location

24437 Katy Fwy Ste 500
Katy, TX 77494-1469

Mailing address

1475 Texas St Unit 1908
Houston, TX 77002-3705
Phone (818) 397-9223

Other practice location 1

4540 Spring Stuebner Rd Ste 500
Spring, TX 77389-1119
Phone (713) 598-0727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221228000178 TX Order and Referring Only - DentistPractitioner - Dentist 2264802784

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39072TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
College Station Oral Surgery, PLLC CurrentSince Feb 12, 2023 Accepting new patients
GS Prosthodontics PLLC CurrentSince Sep 1, 2022 Accepting new patients

Locations

24437 Katy Fwy
Ste 500
Katy, TX 77494
Phone (281) 256-8400

4540 Spring Stuebner Rd
Ste 500
Spring, TX 77389
Phone (713) 598-0727

Organizations & group practices 2

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": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1285357624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 TEXAS ST UNIT 1908",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770023705",
            "telephone_number": "818-397-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24437 KATY FWY STE 500",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774941469",
            "telephone_number": "281-394-9340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4540 Spring Stuebner Rd Ste 500",
            "address_purpose": "LOCATION",
            "city": "Spring",
            "state": "TX",
            "postal_code": "773891119",
            "country_code": "US",
            "telephone_number": "713-598-0727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRZOYAN KALACH",
        "first_name": "TALIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-21",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "39072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.