Firdavs Z Abzhabarov, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14875 Issued in MN

Practice address

12628 Fremont Ave
Zimmerman, MN 55398-9735

Phone

(763) 317-1166

NPI assigned

May 19, 2023

Last updated

May 19, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• PL Dental SC

  • Dental Clinic/Center
  • Zimmerman, MN
  • NPI 1225786411
  NPD
• PL Dental SC

  • Dental Clinic/Center
  • Coon Rapids, MN
  • NPI 1952140691
  NPD (past)

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

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1215628110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 5TH ST SE APT 203",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554141141",
            "telephone_number": "612-360-3964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12628 FREMONT AVE",
            "city": "ZIMMERMAN",
            "state": "MN",
            "postal_code": "553989735",
            "telephone_number": "763-317-1166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9920 Foley Blvd NW Ste 110",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554335216",
            "country_code": "US",
            "telephone_number": "763-317-1166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABZHABAROV",
        "first_name": "FIRDAVS",
        "middle_name": "Z",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-19",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A. J. Linn Chiropractic LLC
• Advocate Urgent Care PLLC
• Advocate Wound Care LLC
• Aegis Group Practice LLC
• Paul C Allegra, MD
• Holly Altenhofen

• General Practice Dentistry in Zimmerman, MN
• Providers in Zimmerman, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; 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.