MEDICARE: MISHA ZAHRA KAZI 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	33454	TX

General Provider Information

NPI Number	:	1568988772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISHA ZAHRA KAZI DDS

Provider Business Mailing Address
First Line	:	4050 SOUTH COLLINS ST.
Second Line	:	STE 300
City	:	ARLINGTON
State	:	TX
Zip	:	76014-4111
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4050 S COLLINS ST
Second Line	:	SUITE 300
City	:	ARLINGTON
State	:	TX
Zip	:	76014-7601
Country	:	US
Telephone Number	:	817-524-6654
Fax Number	:

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

Provider Enumeration Date	:	08/18/2017
Last Update Date	:	02/13/2020

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