Koushan Haidarzadeh Azad, DMD
Individual provider Active NPI General Practice Dentistry · Lompoc, CA
NPI 1154533180 · NPPES record last updated Jul 29, 2026
Key facts
- NPI
- 1154533180
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 019026920 (IL)
- Practice address
- 1009 N H St Ste P
Lompoc, CA 93436-8141 - Phone
- (805) 242-4044
- NPI assigned
- May 3, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL, IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150630000648 | IL | Order and Referring Only - Oral Surgery |
4385956622 | |
| I20150727002470 | IN | Order and Referring Only - Oral Surgery |
4385956622 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Experts, LLC | General Practice | Past | Accepting new patients |
| K. H. Azad Dental Corporation | General Practice | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019026920 | IL | Yes |
Addresses
Primary practice location
1009 N H St Ste P
Lompoc, CA 93436-8141
Mailing address
1009 N H St Ste P
Lompoc, CA 93436-8141
Phone (805) 242-4044
Other practice location 1
1348 E Florence Blvd Ste 7
Casa Grande, AZ 85122-5361
Phone (520) 464-6604
Other practice location 2
272 Reservation Rd
Marina, CA 93933-3178
Phone (831) 200-0747
Other practice location 3
1171 Creston Rd Ste And108
Paso Robles, CA 93446-3031
Phone (805) 434-6747
Other practice location 4
1957 Fremont Blvd
Seaside, CA 93955-3132
Phone (831) 296-1333
Other practice location 5
44770 Valley Central Way
Lancaster, CA 93536-6527
Phone (661) 499-2210
Other practice location 6
3761 Mall View Rd
Bakersfield, CA 93306-3048
Phone (661) 546-9699
Other practice location 7
4221 S H St
Bakersfield, CA 93304-7205
Phone (661) 558-0022
Other practice location 8
3318 Niles St
Bakersfield, CA 93306-4424
Phone (661) 495-5535
Other practice location 9
3870 Broad St Ste 1
San Luis Obispo, CA 93401-7172
Phone (805) 202-4988
Other practice location 10
238 E Betteravia Rd Ste D
Santa Maria, CA 93454-7889
Phone (805) 242-4881
Other providers in Lompoc, CA
- Mark Shoukry Ashamalla
- Michael Mendel Ashnin
- Associated Counseling and Consulting Services
- Helena Avedikian
- Azad Dental Corporation
- Winnie Acosta Badger
- Cristal Bailey
- Rollin C Bailey
- Gowthamy Balakumaran
- Nemesio G. Balcena
All providers in Lompoc, CA · General Practice Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.