Provider Demographics
NPI:1194805549
Name:IRANMEHR, MEHRNAZ (DDS)
Entity type:Individual
Prefix:DR
First Name:MEHRNAZ
Middle Name:
Last Name:IRANMEHR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17000 PRESTON RD STE 170
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1224
Mailing Address - Country:US
Mailing Address - Phone:972-447-9707
Mailing Address - Fax:972-447-9779
Practice Address - Street 1:17000 PRESTON RD STE 170
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1224
Practice Address - Country:US
Practice Address - Phone:972-447-9707
Practice Address - Fax:972-447-9779
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX212691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice