Individual provider Active NPI

Ladan Vatani, DDS

  • General Practice Dentistry
  • Round Rock, TX
National Provider Identifier
1295898039
Registry record updated Feb 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21890 Issued in TX
Practice address
1201 S-Ih 35 Suite 318
Round Rock, TX 78664
Phone
(512) 445-2224
Fax
(512) 445-2224
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2015

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 21890 TX Primary

Addresses

Primary practice location

1201 S-Ih 35 Suite 318
Round Rock, TX 78664

Mailing address

1201 S Ih 35
Round Rock, TX 78664-6615
Phone (512) 416-7737

Other identifiers 1

IdentifierTypeStateIssuer
166417904MedicaidTX

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
21890TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Smiles of Round Rock PA 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424649600000",
    "number": "1295898039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 S IH 35",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786646615",
            "telephone_number": "512-416-7737",
            "fax_number": "512-416-7737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S-IH 35 SUITE 318",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "78664",
            "telephone_number": "512-445-2224",
            "fax_number": "512-445-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VATANI",
        "first_name": "LADAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2015-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166417904",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; 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.