Individual provider Active NPI

Sanaz Ekhlassi, D.D.S.

  • General Practice Dentistry
  • Houston, TX
National Provider Identifier
1720397375
Registry record updated Sep 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
055215-1 Issued in NY
Practice address
1744 Fry Rd
Houston, TX 77084-5801
Phone
(281) 492-8900
Fax
(281) 492-9337
NPI assigned
Sep 30, 2010
Last updated
Sep 30, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 25776 TX
General Practice Dentistry 1223G0001X 055215-1 NY Primary

Addresses

Primary practice location

1744 Fry Rd
Houston, TX 77084-5801

Mailing address

67 Sullivan St Apt D
New York, NY 10012-5134
Phone (281) 382-6526

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

LicenseStateTypeSpecialty
055215-1NYMDGeneral Practice Dentistry
25776TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Briter Dental General Practice Past Accepting new patients

Organizations & group practices 1

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": "1285804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285804800000",
    "number": "1720397375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 SULLIVAN ST APT D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100125134",
            "telephone_number": "281-382-6526",
            "fax_number": "281-492-9337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1744 FRY RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770845801",
            "telephone_number": "281-492-8900",
            "fax_number": "281-492-9337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKHLASSI",
        "first_name": "SANAZ",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-30",
        "last_updated": "2010-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25776",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "055215-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; 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.