Individual provider Active NPI

Mounir Iskandar, DDS

  • General Practice Dentistry
  • Irving, TX
National Provider Identifier
1326294067
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
23921 Issued in TX
Practice address
1235 Kinwest Pkwy
Irving, TX 75063-3403
Phone
(972) 258-1702
NPI assigned
Aug 13, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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 23921 TX Primary

Addresses

Primary practice location

1235 Kinwest Pkwy
Irving, TX 75063-3403

Mailing address

1235 Kinwest Pkwy
Irving, TX 75063-3403
Phone (972) 258-1702

Other identifiers 1

IdentifierTypeStateIssuer
27805703MedicaidTX

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
23921TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
N.E. Dentistry PLLC CurrentSince Jun 21, 2022 Accepting new patients
Radiance Dentistry General Practice CurrentSince Nov 27, 2022 Accepting new patients

Locations

2020 W Rochelle Rd
Irving, TX 75062
Phone (469) 706-9355

1235 Kinwest Pkwy
Irving, TX 75063
Phone (972) 258-1702

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": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1326294067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 KINWEST PKWY",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633403",
            "telephone_number": "972-258-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 KINWEST PKWY",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633403",
            "telephone_number": "972-258-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISKANDAR",
        "first_name": "MOUNIR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-13",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "27805703",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; 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.