Organization Active NPI

Bazargan Family Dentistry PLLC

  • Dentist
  • Scottsdale, AZ
National Provider Identifier
1366817801
Registry record updated Dec 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8563 Issued in AZ
Legal business name
BAZARGAN FAMILY DENTISTRY PLLC
Practice address
9220 E Raintree Dr
Suite 102
Scottsdale, AZ 85260-7589
Phone
(480) 614-4200
NPI assigned
Dec 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2015

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

Authorized official

Name
Dr. Haleh Bazargan, DDS
Title
Owner Dentist
Phone
(631) 388-0906

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 8563 AZ Primary

Addresses

Primary practice location

9220 E Raintree Dr
Suite 102
Scottsdale, AZ 85260-7589

Mailing address

9220 E Raintree Dr
Suite 102
Scottsdale, AZ 85260-7589
Phone (480) 614-4200

Other identifiers 1

IdentifierTypeStateIssuer
758643MedicaidAZ

National Provider Directory

National Provider Directory

Locations

9220 E Raintree Dr
Ste 102
Scottsdale, AZ 85260
Phone (480) 614-4200

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449619200000",
    "number": "1366817801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9220 E RAINTREE DR",
            "address_2": "SUITE 102",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852607589",
            "telephone_number": "480-614-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9220 E RAINTREE DR",
            "address_2": "SUITE 102",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852607589",
            "telephone_number": "480-614-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAZARGAN FAMILY DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-09",
        "last_updated": "2015-12-09",
        "status": "A",
        "authorized_official_last_name": "BAZARGAN",
        "authorized_official_first_name": "HALEH",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "631-388-0906",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "8563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "758643",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; 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.