Active NPI
Medya Roshanrou, DDS
- General Practice Dentistry
- Dallas, TX
National Provider Identifier
1467006650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 35603
- Practice address
- 5848 Abrams Rd
Dallas, TX 75214-1603 - Phone
- (214) 545-0111
- NPI assigned
- Jul 26, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 35603 | TX | Primary |
Addresses
Primary practice location
5848 Abrams Rd
Dallas, TX 75214-1603
Mailing address
5848 Abrams Rd
Dallas, TX 75214-1603
Phone (214) 545-0111
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
| License | State | Type | Specialty |
|---|---|---|---|
| 35603 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564099200000",
"number": "1467006650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5848 ABRAMS RD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752141603",
"telephone_number": "214-545-0111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5848 ABRAMS RD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752141603",
"telephone_number": "214-545-0111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSHANROU",
"first_name": "MEDYA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-26",
"last_updated": "2019-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "35603",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.