Provider Demographics
NPI:1851115166
Name:PEIKAR ORTHODONTICS PLLC
Entity type:Organization
Organization Name:PEIKAR ORTHODONTICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEHDI
Authorized Official - Middle Name:
Authorized Official - Last Name:PEIKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-479-1449
Mailing Address - Street 1:5519 ARAPAHO RD APT 338
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-3645
Mailing Address - Country:US
Mailing Address - Phone:312-479-1449
Mailing Address - Fax:
Practice Address - Street 1:5708 COLLEYVILLE BLVD
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-6064
Practice Address - Country:US
Practice Address - Phone:312-479-1449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty