Shabnam Seyedzadeh Sabounchi

Primary specialty

Orofacial Pain DentistryTaxonomy code 1223X2210X

License

RFD000064 Issued in PA

Practice address

3223 N Broad St
Philadelphia, PA 19140-5007

Phone

(215) 707-2871

NPI assigned

Sep 5, 2023

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

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Temple University of the Commonwealth System of Higher Education

  • Oral and Maxillofacial Surgery (Dentist)
  • Philadelphia, PA
  • NPI 1912687187

  Orofacial Pain

  Medicare reassignment NPD
• Temple University of the Commonwealth System of Higher Education

  • Ambulatory Surgical Clinic/Center
  • Philadelphia, PA
  • NPI 1386646891
  NPD (past)

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1306622543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3223 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405007",
            "telephone_number": "215-707-2871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405007",
            "telephone_number": "215-707-2871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEYEDZADEH SABOUNCHI",
        "first_name": "SHABNAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-05",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401418630",
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "PA",
            "license": "RFD000064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacquelyn Elizabeth Sexton, CRNP
• Janeyne Sexton
• Ryan Vincent Sexton, PT, DPT
• Mark John Sey, M.D.
• Merriam Seyedain, D.M.D., M.S
• John T Seykora, MD
• Seymour Kovnat DDS PC
• Patricia Seymour, CRNA
• SG Senior Living, LLC
• Courtney Lee Sgrillo, CRNP

• Orofacial Pain Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Orofacial Pain Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.