MEDICARE: JAHANDAR FARROKHNEJAD DMD

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	42308	TX

General Provider Information

NPI Number	:	1407788730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAHANDAR FARROKHNEJAD DMD

Provider Business Mailing Address
First Line	:	PO BOX 3568
Second Line	:
City	:	HARKER HEIGHTS
State	:	TX
Zip	:	76548-0559
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 E CENTRAL TEXAS EXPY
Second Line	:
City	:	HARKER HEIGHTS
State	:	TX
Zip	:	76548-5606
Country	:	US
Telephone Number	:	254-698-4698
Fax Number	:

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

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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