Organization Active NPI

Rez Pediatric Dentistry PLLC

  • Dentist
  • Gilbert, AZ
National Provider Identifier
1043744857
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8377 Issued in AZ
Legal business name
REZ PEDIATRIC DENTISTRY PLLC
Practice address
1425 W Elliot Rd # A101
Gilbert, AZ 85233-5129
Phone
(410) 562-8611
NPI assigned
Apr 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

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

Authorized official

Name
Hamed Rezakhan, DDS
Title
Owner
Phone
(410) 562-8611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 8377 AZ Primary

Addresses

Primary practice location

1425 W Elliot Rd # A101
Gilbert, AZ 85233-5129

Mailing address

1425 W Elliot Rd # A101
Gilbert, AZ 85233-5129

National Provider Directory

National Provider Directory

Locations

1425 W Elliot Rd
#A101
Gilbert, AZ 85233
Phone (410) 562-8611

NPI Registry JSON

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492473600000",
    "number": "1043744857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 W ELLIOT RD # A101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852335129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 W ELLIOT RD # A101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852335129",
            "telephone_number": "410-562-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REZ PEDIATRIC DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-18",
        "last_updated": "2017-04-18",
        "status": "A",
        "authorized_official_last_name": "REZAKHAN",
        "authorized_official_first_name": "HAMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-562-8611",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "8377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.