Khodabakhsh, Sasan

Khodabakhsh, Sasan is an sole proprietor health care provider with primary practice located at 3124 W University Dr , Mckinney TX 75071-3018. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Khodabakhsh, Sasan can be contacted via phone (694) 625-0005.

Contact Information

Primary practice address
3124 W University Dr Mckinney TX 75071-3018
Phone: (694) 625-0005
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 22300 Texas

Profile Details

NPI number 1053428755
LBN Legal business name Khodabakhsh, Sasan
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 25th, 2006
Last updated Jan 23rd, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053428755 NPPES
Texas MEDICAID 173282809

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