A.Y. Dental Health, Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN014345 Issued in GA

Legal business name

A.Y. DENTAL HEALTH, INC

Practice address

772 North Ave
Jonesboro, GA 30236-2226

Phone

(770) 892-5328

NPI assigned

Nov 8, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Behnam Yavari

Title

Owner

Phone

(770) 892-5328

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Tara Blvd Family Dentistry Doing business as

Locations

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383868800000",
    "number": "1306275474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "772 NORTH AVE",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302362226",
            "telephone_number": "770-892-5328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "772 NORTH AVE",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302362226",
            "telephone_number": "770-892-5328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A.Y. DENTAL HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-08",
        "last_updated": "2013-11-08",
        "status": "A",
        "authorized_official_last_name": "YAVARI",
        "authorized_official_first_name": "BEHNAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-892-5328",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN014345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003136315A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1235416256",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tara Blvd Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Jonesboro, GA
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; 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.