MEDICARE: MITRA BEHZADI DDS

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	32045	TX

General Provider Information

NPI Number	:	1225582000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MITRA BEHZADI DDS

Provider Business Mailing Address
First Line	:	5416 BASSWOOD BLVD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76137-4400
Country	:	US
Telephone Number	:	817-656-1215
Fax Number	:

Provider Business Practice Location Address
First Line	:	5416 BASSWOOD BLVD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76137-4400
Country	:	US
Telephone Number	:	817-656-1215
Fax Number	:

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

Provider Enumeration Date	:	08/09/2016
Last Update Date	:	04/05/2017

Similar Medicare Providers

1609814060 — ALBERTSONS LLC
Practice Location Address:

4400 WESTERN BLVD
FT. WORTH, TX
76137

Practice Phone: 817-232-1023
Practice Fax: 817-232-5091

1740569144 — ABC123 DENTAL IN HALTOM PLLC
Practice Location Address:

5416 BASSWOOD BLVD
FORT WORTH, TX
76137-4400

Practice Phone: 817-656-1215
Practice Fax: 877-687-6861

1215295175 — HARVEEN DHILLON HANS DDS
Practice Location Address:

5428 BASSWOOD BLVD.
FT. WORTH, TX
76137-4400

Practice Phone: 817-788-7700
Practice Fax: 817-281-0055

1144601071 — LARRY BOOZER
Practice Location Address:

4400 WESTERN CENTER BLVD
FORT WORTH, TX
76137-2044

Practice Phone: 817-232-1023
Practice Fax: 817-232-5091

1235511759 — MS. TAMARA MAYES RPH
Practice Location Address:

4400 WESTERN CENTER BLVD
FORT WORTH, TX
76137-2044

Practice Phone: 817-232-1023
Practice Fax: 817-232-5091

1003284969 — MISS EUNJIN M SUH DDS
Practice Location Address:

5416 BASSWOOD BLVD
FORT WORTH, TX
76137-4400

Practice Phone: 817-656-1215
Practice Fax: 877-230-8349

Directions to “ MITRA BEHZADI DDS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.