Individual provider Active NPI

Nima Deljavan, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Bedford, TX
National Provider Identifier
1306266143
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
30251 Issued in TX
Practice address
2121 Central Dr
Bedford, TX 76021-5884
Phone
(817) 283-5581
NPI assigned
Apr 20, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30251 TX
Student in an Organized Health Care Education/Training Program 390200000X
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 30251 TX Primary

Addresses

Primary practice location

2121 Central Dr
Bedford, TX 76021-5884

Mailing address

2121 Central Dr Ste 1
Bedford, TX 76021-5885
Phone (817) 283-5581

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30251TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ofsa Bedford PLLC Oral and Maxillofacial Surgery CurrentSince Aug 25, 2025 Accepting new patients
Alliance Oral & Maxillofacial Surgery, P.a. Oral and Maxillofacial Surgery PastSince Aug 25, 2025 Accepting new patients
Bedford Assoc in Oral&Maxillofacial Surgery Oral and Maxillofacial Surgery PastSince Aug 25, 2025 Accepting new patients

Locations

2121 Central Dr
Ste 1
Bedford, TX 76021
Phone (817) 283-5581

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": "1397952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1306266143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 CENTRAL DR STE 1",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215885",
            "telephone_number": "817-283-5581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 CENTRAL DR",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760215884",
            "telephone_number": "817-283-5581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELJAVAN",
        "first_name": "NIMA",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-20",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "30251",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "30251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; 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.