NPIMap

Organization Active NPI

Haleh Bazargan DDS PLLC

  • Dentist
  • Camp Verde, AZ
National Provider Identifier
1083027197
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8563 Issued in AZ
Legal business name
HALEH BAZARGAN DDS PLLC
Practice address
430 W Finnie Flat Rd
Camp Verde, AZ 86322-7362
Phone
(928) 567-4108
NPI assigned
Jun 5, 2014
Last updated
Jun 5, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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

Authorized official

Name
Haleh Bazargan, DDSNPI 1588950521
Title
Owner
Phone
(631) 388-0906

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2553 AZ
Dentist 122300000X 8563 AZ Primary
Pediatric Dentistry 1223P0221X 8377 AZ

Addresses

Primary practice location

430 W Finnie Flat Rd
Camp Verde, AZ 86322-7362

Mailing address

430 W Finnie Flat Rd
Camp Verde, AZ 86322-7362

Other identifiers 2

IdentifierTypeStateIssuer
729347MedicaidAZ
758643MedicaidAZ

National Provider Directory

National Provider Directory

Locations

430 W Finnie Flat Rd
Camp Verde, AZ 86322
Phone (480) 309-2150

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401926400000",
    "number": "1083027197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 W FINNIE FLAT RD",
            "city": "CAMP VERDE",
            "state": "AZ",
            "postal_code": "863227362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W FINNIE FLAT RD",
            "city": "CAMP VERDE",
            "state": "AZ",
            "postal_code": "863227362",
            "telephone_number": "928-567-4108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALEH BAZARGAN DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-05",
        "last_updated": "2014-06-05",
        "status": "A",
        "authorized_official_last_name": "BAZARGAN",
        "authorized_official_first_name": "HALEH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-388-0906",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "2553",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "8563",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "8377",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "729347",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "758643",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Verde, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.