MEDICARE: DR. MEHRNAZ IRANMEHR D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	21269	TX

General Provider Information

NPI Number	:	1194805549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEHRNAZ IRANMEHR D.D.S.

Provider Business Mailing Address
First Line	:	17000 PRESTON RD STE 170
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75248-1224
Country	:	US
Telephone Number	:	972-447-9707
Fax Number	:	972-447-9779

Provider Business Practice Location Address
First Line	:	17000 PRESTON RD STE 170
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75248-1224
Country	:	US
Telephone Number	:	972-447-9707
Fax Number	:	972-447-9779

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	03/11/2021

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