Sousan Amiri, D.D.S., P.a

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SOUSAN AMIRI, D.D.S., P.A

Doing business as

Royal Dental Associates

Practice address

4930 Central Ave
Charlotte, NC 28205-5808

Phone

(704) 769-2523

Fax

(888) 975-7633

NPI assigned

Jan 9, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Sousan Amiri, DDS

Title

Owner

Phone

(704) 769-2523

Specialties & licenses 1

Addresses

Other names 1

• Royal Dental Associates Doing business as

Tax ID family

Royal Dental Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sousan Amiri, D.D.S., P.a

  • General Practice Dentistry
  • Charlotte, NC
  • NPI 1114484516
  NPD tax ID

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

{
    "created_epoch": "1546992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546992000000",
    "number": "1083187355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 CENTRAL AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282055808",
            "telephone_number": "704-769-2523",
            "fax_number": "888-975-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4930 CENTRAL AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282055808",
            "telephone_number": "704-769-2523",
            "fax_number": "888-975-7633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 Lake Concord Rd NE",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280253057",
            "country_code": "US",
            "telephone_number": "704-769-2523",
            "fax_number": "888-975-7633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8001 N Tryon St",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623410",
            "country_code": "US",
            "telephone_number": "704-769-2523",
            "fax_number": "888-975-7633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUSAN AMIRI, D.D.S., P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-09",
        "last_updated": "2019-01-09",
        "status": "A",
        "authorized_official_last_name": "AMIRI",
        "authorized_official_first_name": "SOUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-769-2523",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Royal Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Charlotte, NC
• Providers in Charlotte, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; 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.