NPIMap

Organization Active NPI

Coral Dental PLLC

  • Dentist
  • Weslaco, TX
National Provider Identifier
1295349850
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
CORAL DENTAL PLLC
Practice address
1503 N Texas Blvd
Weslaco, TX 78599-4213
Phone
(956) 380-2482
NPI assigned
Sep 1, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Authorized official

Name
Shahrouz Akhavan, DDSNPI 1558687285
Title
Owner
Phone
(956) 380-2482

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1503 N Texas Blvd
Weslaco, TX 78599-4213

Mailing address

307 E University Dr
Edinburg, TX 78539-3549
Phone (956) 380-2482

Other identifiers 1

IdentifierTypeStateIssuer
34127429OtherTXDRIVER LICENSE

National Provider Directory

National Provider Directory

Locations

1503 N Texas Blvd
Weslaco, TX 78599
Phone (956) 380-2482

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": "1598918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598918400000",
    "number": "1295349850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 E UNIVERSITY DR",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785393549",
            "telephone_number": "956-380-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 N TEXAS BLVD",
            "city": "WESLACO",
            "state": "TX",
            "postal_code": "785994213",
            "telephone_number": "956-380-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAL DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A",
        "authorized_official_last_name": "AKHAVAN",
        "authorized_official_first_name": "SHAHROUZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-380-2482",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "34127429",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weslaco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.