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NPI Code Detail

MEDICARE: DR. YASAMIN YAZHARI DDS

MEDICARE: DR. YASAMIN YAZHARI 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
11223P0221XPediatric Dentistry27412TX
21223G0001XGeneral Practice Dentistry27412TX

General Provider Information

NPI Number : 1386926400
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. YASAMIN YAZHARI DDS
Provider Business Mailing Address
First Line : 26615 US HIGHWAY 380 E STE 130
Second Line :
City : PROVIDENCE VILLAGE
State : TX
Zip : 76227-3831
Country : US
Telephone Number : 403-659-4909
Fax Number :
Provider Business Practice Location Address
First Line : 4858 SOUTH FWY
Second Line :
City : FORT WORTH
State : TX
Zip : 76115-3901
Country : US
Telephone Number : 817-927-5800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2011
Last Update Date : 09/26/2019

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