Healthcare Provider Details

I. General information

NPI: 1427505023
Provider Name (Legal Business Name): FARKHANDA AZIM TIRMIZI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 07/28/2020
Certification Date: 07/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 N ZANG BLVD # 110
DALLAS TX
75208-4233
US

IV. Provider business mailing address

4320 LONE ROCK CT
PLANO TX
75024-7315
US

V. Phone/Fax

Practice location:
  • Phone: 214-948-3364
  • Fax: 214-948-1339
Mailing address:
  • Phone: 214-403-0287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number32320
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number32320
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: