1821512146 NPI number — ARMIN ALIEFENDIC , PLLC

Table of content: (NPI 1821512146)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821512146 NPI number — ARMIN ALIEFENDIC , PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARMIN ALIEFENDIC , PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821512146
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1710 W 287 BUSINESS STE 140
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAXAHACHIE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75165-4733
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-351-9700
Provider Business Mailing Address Fax Number:
888-222-9544

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1710 W. 287 BUSINESS
Provider Second Line Business Practice Location Address:
SUITE 140
Provider Business Practice Location Address City Name:
WAXAHACIE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75165
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-351-9700
Provider Business Practice Location Address Fax Number:
888-222-9544
Provider Enumeration Date:
07/28/2017

Additional Information

Authorized Official

Authorized Official Last Name:
ALIEFENDIC
Authorized Official First Name:
ARMIN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/DENTIST
Authorized Official Telephone Number:
972-351-9700

Provider Taxonomy Codes

  • Taxonomy code: 1223P0221X , with the licence number:  31002 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1992829311 . This is a "DR. ALECO TUJIOS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1245783323 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1689766438 . This is a "DR. JON OUSLEY" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 350329402 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 090778403 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1174949101 . This is a "DR. ROMA GANDHI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1245783323 . This is a "DR. SHANNON DE VERA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1174949101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1003229311 . This is a "DR. SHEALA LANSDEN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1407056674 . This is a "DR. JOE PARKER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 187989204 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1992829311 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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