Abtin Etezadi-Tabrizi, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D1506 Issued in SD

Practice address

1700 S Southeastern Ave
Sioux Falls, SD 57103-3227

Phone

(605) 331-5059

Fax

(605) 275-6725

NPI assigned

Jun 9, 2008

Last updated

Apr 14, 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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 5, 2026 through Mar 5, 2028

Specialty

Oral SurgeryAlso: Maxillofacial Surgery

Education

Medical College of Georgia School of Medicine, 2008

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Atlanta Oral & Facial Surgery LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Marietta, GA
  • NPI 1992738165
  NPD
• River Ridge Oral & Maxillofacial Surgical Center

  • Oral and Maxillofacial Surgery (Dentist)
  • Sioux Falls, SD
  • NPI 1376522714
  NPD (past)

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1366601866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 S SOUTHEASTERN AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571033227",
            "telephone_number": "605-331-5059",
            "fax_number": "605-275-6725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S SOUTHEASTERN AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571033227",
            "telephone_number": "605-331-5059",
            "fax_number": "605-275-6725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETEZADI-TABRIZI",
        "first_name": "ABTIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-09",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SD",
            "license": "D1506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Essence Home Care LLC
• Essential Health PLLC
• Kevin Esser
• Ryan Michael Esser, D.C.
• Essilor Laboratories of America, Inc (Twin City Optical)
• Chrisann Marie Etrheim
• Sheila Etrheim, PT
• Dustin Evans, OTR/L
• Erin Evans, CPNP
• Jennifer Evans

• Oral and Maxillofacial Surgery (Dentist) in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Oral and Maxillofacial Surgery (Dentist) in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; 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; Opt Out Affidavits.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.