Hendricks Dental Studio, PA

Primary specialty

DentistTaxonomy code 122300000X

License

DN19121 Issued in FL

Legal business name

HENDRICKS DENTAL STUDIO, PA

Practice address

3557 Hendricks Ave
Jacksonville, FL 32207-5309

Phone

(904) 396-1023

NPI assigned

May 29, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Azadeh Yavari, DDSNPI 1902918543

Title

President

Phone

(904) 396-1023

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Azadeh Yavari, D.D.S.

  • Dentist
  • Jacksonville, FL
  • NPI 1902918543
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464480000000",
    "number": "1023466299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3557 HENDRICKS AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322075309",
            "telephone_number": "904-396-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3557 HENDRICKS AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322075309",
            "telephone_number": "904-396-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDRICKS DENTAL STUDIO, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-29",
        "last_updated": "2016-05-29",
        "status": "A",
        "authorized_official_last_name": "YAVARI",
        "authorized_official_first_name": "AZADEH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-396-1023",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skylar Henderson
• Sydney Henderson
• Kathryn M Hendley, MS-CCC-SLP
• Nathaniel Hendley
• Keiarra Hendrick
• Alissa D Hendricks-Wenger, DO, PHD
• Whitney Alexander Hendricks, LMHC
• Jaia Hendrickson, RBT
• Amber Noel Hendrix, RBT
• Grace Hendrix, PA

• Dentist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.