Individual provider Active NPI

Loubna Tahiri, D.M.D.

  • Periodontics
  • Austin, TX
National Provider Identifier
1376639005
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
21209 Issued in TX
Practice address
12335 Hymeadow Dr
Suite 250
Austin, TX 78750-1934
Phone
(512) 250-5012
Fax
(512) 219-8510
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 21209 TX Primary

Addresses

Primary practice location

12335 Hymeadow Dr
Suite 250
Austin, TX 78750-1934

Mailing address

8600 Ranch Road 620 N
Apt. 1524
Austin, TX 78726-3502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160418001794 TX Order and Referring Only - DentistPractitioner - Dentist 0143528570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21209TXMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Dental Group 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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376639005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 RANCH ROAD 620 N",
            "address_2": "APT. 1524",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787263502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12335 HYMEADOW DR",
            "address_2": "SUITE 250",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787501934",
            "telephone_number": "512-250-5012",
            "fax_number": "512-219-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAHIRI",
        "first_name": "LOUBNA",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "21209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.