Individual provider Active NPI

Imaan Alaidroos, MD

  • Psychiatry Physician
  • Dallas, TX
National Provider Identifier
1902396492
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
U8504 Issued in TX
Practice address
17610 Preston Rd Ste 1
Dallas, TX 75252-5734
Phone
(469) 715-4165
NPI assigned
May 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X U8504 TX Primary
Psychiatry Physician 2084P0800X A166607 CA

Addresses

Primary practice location

17610 Preston Rd Ste 1
Dallas, TX 75252-5734

Mailing address

17610 Preston Rd Ste 1
Dallas, TX 75252-5734
Phone (469) 715-4165

Other identifiers 1

IdentifierTypeStateIssuer
39020000XOther39

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 5, 2022 through Dec 5, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A166607CAMDPsychiatry Physician
U8504TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sage Psychiatry Associates Psychiatry CurrentSince Sep 21, 2025 Accepting new patients

Locations

17610 Preston Rd
Ste 1
Dallas, TX 75252
Phone (469) 715-4165

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": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1902396492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17610 PRESTON RD STE 1",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752525734",
            "telephone_number": "469-715-4165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17610 PRESTON RD STE 1",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752525734",
            "telephone_number": "469-715-4165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAIDROOS",
        "first_name": "IMAAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-10",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "U8504",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A166607",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "39",
            "identifier": "39020000X",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.