Active NPI
Dawit Kidane
- Pharmacist
- Dallas, TX
National Provider Identifier
1558967448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 59027
- Practice address
- 8555 Ferguson Rd
Dallas, TX 75228-5343 - Phone
- (214) 320-0892
- Fax
- (214) 320-1118
- NPI assigned
- Dec 7, 2020
- Last updated
- Dec 7, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 59027 | TX | Primary |
Addresses
Primary practice location
8555 Ferguson Rd
Dallas, TX 75228-5343
Mailing address
2413 Resort Dr
Heath, TX 75126-0975
Phone (469) 878-5963
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 |
|---|---|---|---|
| 59027 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past | Accepting new patients | |
| CVS Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607299200000",
"number": "1558967448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2413 RESORT DR",
"city": "HEATH",
"state": "TX",
"postal_code": "751260975",
"telephone_number": "469-878-5963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8555 FERGUSON RD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752285343",
"telephone_number": "214-320-0892",
"fax_number": "214-320-1118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDANE",
"first_name": "DAWIT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-07",
"last_updated": "2020-12-07",
"certification_date": "2020-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "59027",
"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 Dec 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.