Pedram Mir Aghazadeh, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13168 Issued in TN

Practice address

4453 Highway 11 E
Bluff City, TN 37618-2407

Phone

(423) 391-8004

NPI assigned

May 18, 2026

Last updated

Jul 10, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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

{
    "created_epoch": "1779062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1285563924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4453 HIGHWAY 11 E",
            "city": "BLUFF CITY",
            "state": "TN",
            "postal_code": "376182407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4453 HIGHWAY 11 E",
            "city": "BLUFF CITY",
            "state": "TN",
            "postal_code": "376182407",
            "telephone_number": "423-391-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIR AGHAZADEH",
        "first_name": "PEDRAM",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-18",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "13168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristy Renee Houghton, FNP
• Arlene Kellum, DDS
• Andrew Monteith Macconnell, DDS, MIIF, DABOI/ID
• Kathryn Lee Maclucas, ATC, LAT
• Lisa Janet Malone, RN
• Logan Chayse Nutter
• Kaushal Patel, DDS
• Catherine H Powers, FNP
• Rural Health Services Consortium of Upper East Tennessee Inc (Bluff City Medical Center)
• Jonathan Todd Simmons, RN

• General Practice Dentistry in Bluff City, TN
• Providers in Bluff City, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.