Individual provider Active NPI

Maheeb Jaouni, B.D.S. , D.D.S., M.S

  • Endodontics
  • Garland, TX
National Provider Identifier
1942437025
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
25600 Issued in TX
Practice address
4880 N President George Bush Hwy # 102
Garland, TX 75040-2742
Phone
(972) 496-0164
Fax
(972) 295-9323
NPI assigned
Jun 16, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14284 MD
Dentist 122300000X 55393 CA
Endodontics 1223E0200X 25600 TX Primary

Addresses

Primary practice location

4880 N President George Bush Hwy # 102
Garland, TX 75040-2742

Mailing address

4880 N President George Bush Hwy Ste 102
Garland, TX 75040-2742
Phone (972) 496-0164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160115000580 TX Order and Referring Only - DentistPractitioner - Dentist 0446553028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
14284MDMDSocial Worker
55393CAMDDentist
25600TXMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
The Endodontic Specialists, PLLC Endodontics CurrentSince Aug 18, 2024 Accepting new patients
The Endodontic Specialists, PLLC Endodontics PastSince Aug 4, 2024 Accepting new patients

Locations

4880 N President George Bush Hwy
Ste 102
Garland, TX 75040
Phone (469) 416-7084

Organizations & group practices 2

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": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1942437025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4880 N PRESIDENT GEORGE BUSH HWY STE 102",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750402742",
            "telephone_number": "972-496-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4880 N PRESIDENT GEORGE BUSH HWY # 102",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750402742",
            "telephone_number": "972-496-0164",
            "fax_number": "972-295-9323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAOUNI",
        "first_name": "MAHEEB",
        "name_prefix": "Dr.",
        "credential": "B.D.S. , D.D.S., M.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-16",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "14284",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "55393",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "25600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.