Fa Dental Pllcs

Primary specialty

DentistTaxonomy code 122300000X

License

27586 Issued in TX

Legal business name

FA DENTAL PLLCS

Practice address

817 W Pioneer Pkwy
Suite 150
Grand Prairie, TX 75051-4710

Phone

(702) 275-9460

NPI assigned

Mar 5, 2015

Organization subpart

No

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

Authorized official

Name

Farnaz Athari, DDS

Title

Dentist

Phone

(702) 275-9460

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425513600000",
    "number": "1609269380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6034 PALO PINTO AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752066834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 W PIONEER PKWY",
            "address_2": "SUITE 150",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750514710",
            "telephone_number": "702-275-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FA DENTAL PLLCS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-05",
        "last_updated": "2015-03-05",
        "status": "A",
        "authorized_official_last_name": "ATHARI",
        "authorized_official_first_name": "FARNAZ",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "702-275-9460",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "27586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.