Organization Active NPI

Rodeo Edinburg & Orthodontics, PLLC

  • General Practice Dentistry
  • Fort Worth, TX
National Provider Identifier
1336594183
Registry record updated Apr 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
RODEO EDINBURG & ORTHODONTICS, PLLC
Practice address
100 E 15TH St Ste 520
Fort Worth, TX 76102-6566
Phone
(817) 529-8151
NPI assigned
Apr 29, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2016

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

Authorized official

Name
Dr. Saam Zarrabi
Title
Owner
Phone
(817) 529-8151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

100 E 15TH St Ste 520
Fort Worth, TX 76102-6566

Mailing address

100 E 15TH St Ste 520
Fort Worth, TX 76102-6566
Phone (817) 529-8151

Other identifiers 5

IdentifierTypeStateIssuer
182419510MedicaidTX
182419511MedicaidTX
182419513MedicaidTX
182419514MedicaidTX
182419515MedicaidTX

National Provider Directory

National Provider Directory

Locations

100 E 15th St
Ste 520
Fort Worth, TX 76102
Phone (214) 732-0570

NPI Registry JSON

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

{
    "created_epoch": "1461888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461888000000",
    "number": "1336594183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E 15TH ST STE 520",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761026566",
            "telephone_number": "817-529-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 15TH ST STE 520",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761026566",
            "telephone_number": "817-529-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RODEO EDINBURG & ORTHODONTICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-29",
        "last_updated": "2016-04-29",
        "status": "A",
        "authorized_official_last_name": "ZARRABI",
        "authorized_official_first_name": "SAAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-529-8151",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182419510",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182419511",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182419513",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182419514",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182419515",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; 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.