Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1356085336 Individual Practitioner Female Practitioner

Dr. Mitra Nikpour , DDS

Dentist - General Practice • Tyler, TX

Professional Overview & Biography Verified Profile Summary

Dr. Mitra Nikpour, DDS is a registered healthcare professional specializing in Dentist - General Practice in Tyler, TX. Practice services are available at 4164 S BROADWAY AVE # 822 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4164 S Broadway Ave # 822

Tyler, TX 757018719

Telephone 6262222427
Associated Practice Facility / Clinic
🏢 Kunduru Dental Pllc Facility NPI 1629598586

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Tyler, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.3 Yrs
Regional Practice Density
84 Specialists

Practicing in Tyler, TX (10570 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-08-12
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License TX 39056

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Business Mailing Address August 14, 2023

Registered at 4164 S BROADWAY AVE, TYLER, TX 757018719 (Tel: 9039390703)

📍
Updated Practice Location September 13, 2022

Registered at 4164 S BROADWAY AVE # 822, TYLER, TX 757018719 (Tel: 6262222427)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 13, 2022

Dentist (License #39056 in TX)

NPI Profile Active April 25, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location April 25, 2022

Registered at 335 VIA MORENO, PHILLIPS RANCH, CA 917668600 (Tel: 6262222427)

📍
Updated Business Mailing Address April 25, 2022

Registered at 335 VIA MORENO, PHILLIPS RANCH, CA 917668600 (Tel: 6262222427)

👤
Provider Name / Credentials Updated April 25, 2022

Recorded as MITRA NIKPOUR, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 25, 2022

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 25, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1356085336
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 25, 2022
Last Update: August 14, 2023
Sole Proprietor: Yes

Mailing Address

4164 S Broadway Ave

Tyler, TX 757018719

Phone: 9039390703

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.