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General NPI Number Information
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NPI Number | 1215247911
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Entity Type | Individual
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Provider Name | AMIRALI TAHBAZ D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 10/14/2010
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 1700 W PARMER LN SUITE 250
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City | AUSTIN
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State | TX
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Zip | 78727-4604
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Country | US
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Telephone | 702-526-6711
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 W PARMER LN STE 250
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City | AUSTIN
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State | TX
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Zip | 78727-4609
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Country | US
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Telephone | 512-351-8362
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6088
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 28708
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License Number State | TX
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