MEDICARE: CASA VIEW DENTAL AND ORTHODONTICS PLLC

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	122300000X	Dentist

General Provider Information

NPI Number	:	1467937839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CASA VIEW DENTAL AND ORTHODONTICS PLLC

Provider Business Mailing Address
First Line	:	2540 GUS THOMASSON RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-3017
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2514 GUS THOMASSON RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-3040
Country	:	US
Telephone Number	:	817-529-8151
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SAAM ZARRABI
Credential	:
Telephone Number	:	817-529-8151

Provider Enumeration Date	:	10/01/2018
Last Update Date	:	02/04/2019

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