Siavash Shaddel-, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

17641 Issued in TX

Practice address

101 E Randol Mill Rd
Suite 107
Arlington, TX 76011-4610

Phone

(817) 277-8847

Fax

(817) 277-9550

NPI assigned

Dec 29, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Arlington Family Dental Centre, PA

  • General Practice Dentistry
  • Arlington, TX
  • NPI 1295785129
  NPD (past) Authorized official

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396722385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E RANDOL MILL RD",
            "address_2": "SUITE 107",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760114610",
            "telephone_number": "817-277-8847",
            "fax_number": "817-277-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E RANDOL MILL RD",
            "address_2": "SUITE 107",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760114610",
            "telephone_number": "817-277-8847",
            "fax_number": "817-277-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADDEL-",
        "first_name": "SIAVASH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "17641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seven Star Transport LLC
• Kathryn Teresa Sexton, LCSW
• Gina Irene Seymour, O.D.
• SGH Pediatrics, PLLC
• SH Dental PLLC (Matlock Family Dental)
• James R Shadle Jr., D.D.S.
• Mary Grace Shafer, CCC-SLP
• Atulkumar Thakorlal Shah, M.D.
• Jilpa Shah
• Prachi D Shah, D.D.S

• General Practice Dentistry in Arlington, TX
• Providers in Arlington, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.