Provider Demographics
NPI:1285112318
Name:KHALIGHINEJAD, NAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:NAVID
Middle Name:
Last Name:KHALIGHINEJAD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3355 BLACKBURN ST APT 5202
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-1580
Mailing Address - Country:US
Mailing Address - Phone:469-360-8414
Mailing Address - Fax:
Practice Address - Street 1:2201 MARTIN DR # BEDFORD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-5997
Practice Address - Country:US
Practice Address - Phone:817-283-5544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX344781223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics