Dr Azizi PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DR AZIZI PLLC

Practice address

1538 11TH Ave
Longview, WA 98632-4123

Phone

(323) 804-1324

NPI assigned

Oct 18, 2022

Organization subpart

No

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

Authorized official

Name

Hamid AziziNPI 1598200610

Title

Owner

Phone

(323) 804-1324

Specialties & licenses 1

Addresses

Other names 1

• GRACE FAMILY DENTAL Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hamid Azizi, DDS

  • Dentist
  • Vancouver, WA
  • NPI 1598200610
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666051200000",
    "number": "1275259582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3984 NW CURRAWONG CT",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986078521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1538 11TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324123",
            "telephone_number": "323-804-1324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR AZIZI PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-12",
        "status": "A",
        "authorized_official_last_name": "AZIZI",
        "authorized_official_first_name": "HAMID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-804-1324"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRACE FAMILY DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Donald G. Echols DDS
• Jodi A Donaldson, LICSW
• Hannah J Donayri, BA, C-AAC
• Jessica Doughty, DPT, PT
• Trudy Martine Doyle, PA-C
• Dr. Julia Gourley DMD PC
• David I Dropkin, MA
• Renee Ducharme-Brodie, LMHC
• Megan Chono Dudley, M.D.
• Lisa Renee Dull

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.