Fatima Naurose Siraj, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

019030215 Issued in IL

Practice address

860 East Highway 114 Ideal Dental
Suite 200
Roanoke, TX 76262

Phone

(817) 491-3000

Fax

(214) 291-9582

NPI assigned

Jul 7, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Ideal Dental of Roanoke PLLC

  • Dentist
  • Roanoke, TX
  • NPI 1306225529
  NPD (past)

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1942683115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 NOCONA DRIVE,",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "75063",
            "telephone_number": "847-668-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 EAST HIGHWAY 114 IDEAL DENTAL",
            "address_2": "SUITE 200",
            "city": "ROANOKE",
            "state": "TX",
            "postal_code": "76262",
            "telephone_number": "817-491-3000",
            "fax_number": "214-291-9582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRAJ",
        "first_name": "FATIMA",
        "middle_name": "NAUROSE",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019030215",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019030215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Sanchez
• Auttaria Shinault
• Clara Silbernagel, A.T.C., L.A.T.
• Silver Lifts Transportation Company LLC
• Barry Eugene Simpson, D.C.
• Six Day Dental & Orthodontics N Texas PA
• Margie Marie Spence, L.M., C.P.M.
• Julie Welwood Spencer, M.ED.
• Step by Step Communications LLC
• Taylor Michelle Stone

• Dentist in Roanoke, TX
• Providers in Roanoke, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.