Individual provider Active NPI

Delaram Mostafavi, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Irving, TX
National Provider Identifier
1730793555
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
35374 Issued in TX
Practice address
3200 N Macarthur Blvd
Irving, TX 75062-4404
Phone
(972) 252-1600
NPI assigned
Aug 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 35374 TX
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 35374 TX Primary

Addresses

Primary practice location

3200 N Macarthur Blvd
Irving, TX 75062-4404

Mailing address

3883 Turtle Creek Blvd Apt 1704
Dallas, TX 75219-4465
Phone (214) 843-5517

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
35374TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Eyecare of North Texas, PLLC PastSince Sep 6, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1730793555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3883 TURTLE CREEK BLVD APT 1704",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194465",
            "telephone_number": "214-843-5517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 N MACARTHUR BLVD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750624404",
            "telephone_number": "972-252-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSTAFAVI",
        "first_name": "DELARAM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-31",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "35374",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "35374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.