Individual provider Active NPI

Azadeh Eslami Amin, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Saint Louis, MO
National Provider Identifier
1164860490
Registry record updated Jun 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
V177181001 Issued in MO
Practice address
3320 Rutger St
Saint Louis, MO 63104-1122
Phone
(314) 977-8363
NPI assigned
Jun 9, 2013
Last updated
Jun 9, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X V177181001 MO Primary

Addresses

Primary practice location

3320 Rutger St
Saint Louis, MO 63104-1122

Mailing address

1520 Washington Ave
Apt. 710
Saint Louis, MO 63103-1840
Phone (810) 333-3930

Other names 1

  • Dr. Azadeh Eslami Former name

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

LicenseStateTypeSpecialty
V177181001MOMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Smile in Style PLLC Orthodontics and Dentofacial Orthopedics CurrentSince Aug 8, 2021 Accepting new patients

Locations

2515 S Lakeline Blvd
Cedar Park, TX 78613
Phone (214) 346-0450

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": "1370736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370736000000",
    "number": "1164860490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 WASHINGTON AVE",
            "address_2": "APT. 710",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631031840",
            "telephone_number": "810-333-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 RUTGER ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041122",
            "telephone_number": "314-977-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESLAMI AMIN",
        "first_name": "AZADEH",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-09",
        "last_updated": "2013-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MO",
            "license": "V177181001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AZADEH",
            "last_name": "ESLAMI",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2013; 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.