Individual provider Active NPI

Farnaz Nicki Tajalli, D.D.S.

  • Dentist
  • Houston, TX
National Provider Identifier
1285643692
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
18889 Issued in TX
Practice address
4900 Woodway Dr Ste 730
Houston, TX 77056-1847
Phone
(713) 963-9191
Fax
(281) 754-4352
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 18889 TX Primary

Addresses

Primary practice location

4900 Woodway Dr Ste 730
Houston, TX 77056-1847

Mailing address

13630 Beamer Rd
Suite 112
Houston, TX 77089-6069
Phone (281) 481-2273

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
I20170705003456 TX Order and Referring Only - DentistPractitioner - Dentist 2860761988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18889TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Uptown Dentistry, P.C. Dentist CurrentSince Jul 21, 2024 Accepting new patients
Dental Boutique PLLC Dentist Past Accepting new patients
South Belt Dental, P.a. Dentist Past Accepting new patients

Locations

4900 Woodway Dr
Ste 730
Houston, TX 77056
Phone (713) 963-9191

Organizations & group practices 3

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1285643692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13630 BEAMER RD",
            "address_2": "SUITE 112",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770896069",
            "telephone_number": "281-481-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 WOODWAY DR STE 730",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770561847",
            "telephone_number": "713-963-9191",
            "fax_number": "281-754-4352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAJALLI",
        "first_name": "FARNAZ",
        "middle_name": "NICKI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "18889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.