Individual provider Active NPI

Nabeel Arif Kheiri, DDS

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1740691393
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
34604 Issued in TX
Practice address
5330 E Mockingbird LN Ste 120
Dallas, TX 75206-0941
Phone
(214) 821-5011
NPI assigned
May 16, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019029892 IL
General Practice Dentistry 1223G0001X 34604 TX Primary

Addresses

Primary practice location

5330 E Mockingbird LN Ste 120
Dallas, TX 75206-0941

Mailing address

5330 E Mockingbird LN Ste 120
Dallas, TX 75206-0941
Phone (214) 821-5011

Other practice location 1

350 N Clark St
Suite 600
Chicago, IL 60654-4712
Phone (312) 274-4524

Other practice location 2

4251 E Renner Rd Ste 126
Richardson, TX 75082-2753
Phone (214) 821-6468

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
019029892ILMDDentist
34604TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mint Dentistry Dentist PastSince Aug 2, 2020 Accepting new patients
Mint Surgery Center PLLC Dentist PastSince Aug 2, 2020 Accepting new patients
Mint Dentistry, PLLC General Practice Past Accepting new patients

Organizations & group practices 3

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": "1400198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1740691393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5330 E MOCKINGBIRD LN STE 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752060941",
            "telephone_number": "214-821-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 E MOCKINGBIRD LN STE 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752060941",
            "telephone_number": "214-821-5011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 N Clark St",
            "address_2": "Suite 600",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606544712",
            "country_code": "US",
            "telephone_number": "312-274-4524",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4251 E Renner Rd Ste 126",
            "address_purpose": "LOCATION",
            "city": "Richardson",
            "state": "TX",
            "postal_code": "750822753",
            "country_code": "US",
            "telephone_number": "214-821-6468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHEIRI",
        "first_name": "NABEEL",
        "middle_name": "ARIF",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-16",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029892",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34604",
            "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 Jul 30, 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.

Verify at the official NPI Registry.