Nicole Fallahzadeh, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

7878 Issued in KY

Practice address

4384 Clearwater Way
Ste 110
Lexington, KY 40515-6337

Phone

(859) 913-4472

NPI assigned

Dec 8, 2006

Sex

Female

Sole proprietor

Yes

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 KY

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

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.

• Veterans Park Family Dentistry PLLC

  • Dentist
  • Lexington, KY
  • NPI 1992871644
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1609935220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4384 CLEARWATER WAY STE 110",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405156479",
            "telephone_number": "859-913-4472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4384 CLEARWATER WAY",
            "address_2": "STE 110",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405156337",
            "telephone_number": "859-913-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLAHZADEH",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "7878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toufic A Fakhoury, MD
• Donald A Falace, DMD
• John Michael Falace, DMD
• Adesuwa Omolara Falade
• Ireland Falconberry
• Keisa Fallin-Bennett, MD, MPH
• Candice Dawn Falls, ARNP
• Emma Tala Sophia Falluji
• Reem Kasim Falluji, M.D.
• Maged D. Fam, MD

• Dentist in Lexington, KY
• Providers in Lexington, KY by specialty
• Dentist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.