Individual provider Active NPI

Lyda Harandifassih, DDS

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1114078086
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN011437 Issued in GA
Practice address
3365 Piedmont Rd NE
Suite 1110
Atlanta, GA 30305-1794
Phone
(404) 237-3070
Fax
(404) 237-4561
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN011437 GA Primary

Addresses

Primary practice location

3365 Piedmont Rd NE
Suite 1110
Atlanta, GA 30305-1794

Mailing address

3362 Piedmont Road, N.E.
Suite 1110
Atlanta, GA 30305
Phone (404) 237-3070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160322002347 GA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1254638075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Harandi, Harandi, Spelios and Associates Buckhead LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114078086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3362 PIEDMONT ROAD, N.E.",
            "address_2": "SUITE 1110",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30305",
            "telephone_number": "404-237-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3365 PIEDMONT RD NE",
            "address_2": "SUITE 1110",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051794",
            "telephone_number": "404-237-3070",
            "fax_number": "404-237-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARANDIFASSIH",
        "first_name": "LYDA",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN011437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.