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3515 N Loy Lake Rd Sherman TX 75090-2506 | |
| (903) 487-7777 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 3515 N Loy Lake Rd, Sherman, Texas |
| Authorized Official Name and Position | Mehrad Sadeghpour (OWNER) |
| Authorized Official Contact | 4697349380 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
3515 N Loy Lake Rd Sherman TX 75090-2506 Ph: (903) 487-7777 | 3515 N Loy Lake Rd Sherman TX 75090-2506 Ph: (903) 487-7777 |
| NPI Number | 1861152068 |
|---|---|
| Provider Enumeration Date | 12/29/2021 |
| Last Update Date | 06/11/2024 |
| Medicare PECOS PAC ID | 7517402225 |
|---|---|
| Medicare Enrollment ID | O20240717001582 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861152068 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| Provider Name | Mehrad Sadeghpour |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1437637618 PECOS PAC ID: 0244628956 Enrollment ID: I20211029001637 |
| Provider Name | Amin Reza Heravi |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1306416490 PECOS PAC ID: 3375089204 Enrollment ID: I20240726001926 |
| Provider Name | Paola Andrea Pinzon |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1083137582 PECOS PAC ID: 4981140860 Enrollment ID: I20240727000261 |
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