Laith Azzouni, DMD
Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · Auburn, MA
NPI 1023288347 · NPPES record last updated Sep 28, 2018
Key facts
- NPI
- 1023288347
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- DN1855086 (MA)
- Practice address
- 390 Southbridge St
Auburn, MA 01501 - Phone
- (508) 832-0919
- Fax
- (508) 832-0426
- NPI assigned
- Mar 3, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN18560 | FL | MD | Oral and Maxillofacial Surgery (Dentist) |
| DN1855086 | MA | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Geisinger Clinic | Oral and Maxillofacial Surgery | Past | Accepting new patients |
| Coral Springs Modern Dentistry, PA | Past | Accepting new patients | |
| Auburn Oral Surgery & Implant Center | Oral and Maxillofacial Surgery | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | DN18560 | FL | |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | DN1855086 | MA | Yes |
Addresses
Primary practice location
390 Southbridge St
Auburn, MA 01501
Mailing address
390 Southbridge St
Auburn, MA 01501-2456
Phone (508) 832-0919
Other practice location 1
311 Commonwealth Ave
back Bay oral and maxillofacial surgery & implant cent
Boston, MA 02115-1926
Phone (617) 267-4777
Other practice location 2
5810 Wiles Rd
Coral Springs, FL 33067-2158
Phone (954) 314-8343
Other providers in Auburn, MA
- Auburn Primary Care and Aesthetics
- Auburn Vision Center Inc
- Auburn Vna Extended Care
- Auburn Vna Health Network, Inc.
- Auburn Youth and Family Services
- Kelley Bailey
- Pamela Baker
- Balian Family Dental
- Arthur Y Balian
- Kaitlyn Mae Banks
All providers in Auburn, MA · Oral and Maxillofacial Surgery (Dentist) in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.