Abrah M Goudarzi, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE00006151 Issued in WA

Practice address

4111 194TH St SW
Lynnwood, WA 98036-4604

Phone

(425) 835-5204

Fax

(425) 835-5205

NPI assigned

Oct 18, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Community Health Center of Snohomish County

  • Federally Qualified Health Center (FQHC)
  • Everett, WA
  • NPI 1023830346
  NPD (past)
• Community Health Center of Snohomish County

  • Federally Qualified Health Center (FQHC)
  • Everett, WA
  • NPI 1730136367
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1225119944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 194TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364604",
            "telephone_number": "425-835-5204",
            "fax_number": "425-835-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 194TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364604",
            "telephone_number": "425-835-5204",
            "fax_number": "425-835-5205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUDARZI",
        "first_name": "ABRAH",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00006151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5004486",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Good Dental & Dentures (Excel dental & dentures)
• Good Doctor Chiropractic LLC (Good Doctor Chiropractic Clinic)
• Norman P. Goodwin
• Rachel Claire Goodwin
• Ann M Gorman, RPH
• Andrea Gould, LMHCA
• Sejal Parekh Graber, ARNP
• Grace Hsiao Wu DMD, MPH, PLLC (Alderwood Endodontics)
• Joy Lynne Graves, M.S., LMFT
• Melissa Catherine Graves, LMT

• Dentist in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.