Keyvan Namazi Matteo, DDS
Individual provider Active NPI Denturist · Bellmead, TX
NPI 1487215018 · NPPES record last updated Jun 25, 2019
Key facts
- NPI
- 1487215018
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Denturist 122400000X
- License
- 35413 (TX)
- Practice address
- 121 Eastgate PLZ
Bellmead, TX 76705-2868 - Phone
- (254) 799-4867
- NPI assigned
- Jun 25, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35413 | TX | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fusion Dental- Hewitt PLLC | Past | Accepting new patients | |
| Waco Family Dental PLLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Denturist | 122400000X | 35413 | TX | Yes |
Addresses
Primary practice location
121 Eastgate PLZ
Bellmead, TX 76705-2868
Mailing address
5705B Elephant Butte
Waco, TX 76708-7501
Other providers in Bellmead, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.