Azadeh Paydar, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

39695 Issued in CA

Practice address

12729 Foothill Blvd
Suite # a
Rancho Cucamonga, CA 91739-9334

Phone

(909) 899-8757

Fax

(909) 899-8760

NPI assigned

May 27, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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 and National Provider Directory roles.

• Etemadi Dental Corporation

  • Dentist
  • Rancho Cucamonga, CA
  • NPI 1699842492
  NPD (past)

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1245498229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12729 FOOTHILL BLVD",
            "address_2": "SUITE # A",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917399334",
            "telephone_number": "909-899-8757",
            "fax_number": "909-899-8760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12729 FOOTHILL BLVD",
            "address_2": "SUITE # A",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917399334",
            "telephone_number": "909-899-8757",
            "fax_number": "909-899-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYDAR",
        "first_name": "AZADEH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-27",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "39695",
            "primary": true
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "CA",
            "license": "39695",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Athanase Pavlidis, LMFT
• Susan Lynn Pavone, L.M.F.T.
• Jeffrey Scott Paxman, D.D.S
• Darlyn Kimberly Payan Diego
• Kilee Renee Payan-Garcia
• Lydia Payne
• Ashley Paz, PT
• Peaceful Journey Hospice Care, Inc.
• General Raymond Pearson Jr., DDS
• Olivia Pearson

• Dentist in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; 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.