Shahla S Azhdari, DDS MS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS0000004256 Issued in TN

Practice address

2280 Fairview Blvd
Fairview, TN 37062

Phone

(615) 799-2090

Fax

(615) 799-2038

NPI assigned

Jul 21, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TN

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

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386664217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 FAIRVIEW BLVD",
            "address_2": "PO BOX 539",
            "city": "FAIRVIEW",
            "state": "TN",
            "postal_code": "37062",
            "telephone_number": "615-799-2090",
            "fax_number": "615-799-2038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 FAIRVIEW BLVD",
            "city": "FAIRVIEW",
            "state": "TN",
            "postal_code": "37062",
            "telephone_number": "615-799-2090",
            "fax_number": "615-799-2038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZHDARI",
        "first_name": "SHAHLA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS  MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS0000004256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "858251",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "0056642",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0004944",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Advanced Diagnostic Imaging, PC (Covenant Medical Group)
• Advanced Foot & Ankle Care Centers, PC (Fairview Foot & Ankle Center)
• James Marshal Anderson Jr., B.S., D.PH.
• Rachelle A Armistead, DPT
• Jane Barnes, M.ED., BCBA
• Katie Elizabeth Barnes
• Tim Beckner
• Zachary Bennett, DPT
• Bloom and Blossom, LLC

• General Practice Dentistry in Fairview, TN
• Providers in Fairview, 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 8, 2007; 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.