Active NPI
Jood Bazerbashi, DDS
- Dentist
- Altamonte Springs, FL
National Provider Identifier
1093317703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN25373
- Practice address
- 604 Maitland Ave
Altamonte Springs, FL 32701-6834 - Phone
- (407) 915-4828
- NPI assigned
- Nov 9, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN25373 | FL | Primary |
Addresses
Primary practice location
604 Maitland Ave
Altamonte Springs, FL 32701-6834
Mailing address
257 Killington Way
Orlando, FL 32835-6841
Phone (832) 661-8720
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN25373 | FL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| W&J Dental LLC | Current | Accepting new patients |
Networks
- Freedom Health HMO Network
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604880000000",
"number": "1093317703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "257 KILLINGTON WAY",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328356841",
"telephone_number": "832-661-8720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "604 MAITLAND AVE",
"city": "ALTAMONTE SPRINGS",
"state": "FL",
"postal_code": "327016834",
"telephone_number": "407-915-4828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAZERBASHI",
"first_name": "JOOD",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-09",
"last_updated": "2020-11-09",
"certification_date": "2020-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN25373",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Altamonte Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.