Active NPI
Mutahara Azeeza, DDS
- Dentist
- Wylie, TX
National Provider Identifier
1851286389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 41436
- Practice address
- 3483 W FM 544 Ste 112
Wylie, TX 75098-9402 - Phone
- (612) 913-6744
- NPI assigned
- Jun 12, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 41436 | TX | Primary |
Addresses
Primary practice location
3483 W FM 544 Ste 112
Wylie, TX 75098-9402
Mailing address
512 Sierra Blanca Pass
Irving, TX 75063-4649
Phone (612) 913-6744
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
| License | State | Type | Specialty |
|---|---|---|---|
| 41436 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1749686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749686400000",
"number": "1851286389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "512 SIERRA BLANCA PASS",
"city": "IRVING",
"state": "TX",
"postal_code": "750634649",
"telephone_number": "612-913-6744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3483 W FM 544 STE 112",
"city": "WYLIE",
"state": "TX",
"postal_code": "750989402",
"telephone_number": "612-913-6744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AZEEZA",
"first_name": "MUTAHARA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-06-12",
"last_updated": "2025-06-12",
"certification_date": "2025-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "41436",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wylie, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.