Individual provider Active NPI

Atousa Bashardoost Safavi, DDS

  • Dentist
  • Denver, CO
National Provider Identifier
1407236631
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN.00202760 Issued in CO
Practice address
2101 S Clermont St
Denver, CO 80222-5006
Phone
(303) 691-3333
NPI assigned
Jun 3, 2015
Last updated
Aug 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN.00202760 CO Primary

Addresses

Primary practice location

2101 S Clermont St
Denver, CO 80222-5006

Mailing address

2101 S Clermont St
Denver, CO 80222-5006
Phone (303) 691-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20150914002691 NC Order and Referring Only - DentistPractitioner - Dentist 3870800436

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN.00202760COMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Abs Dentistry PLLC CurrentSince Dec 9, 2019 Accepting new patients

Locations

2101 S Clermont St
Denver, CO 80222
Phone (303) 691-3333

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1407236631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 S CLERMONT ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802225006",
            "telephone_number": "303-691-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 S CLERMONT ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802225006",
            "telephone_number": "303-691-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFAVI",
        "first_name": "ATOUSA",
        "middle_name": "BASHARDOOST",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-03",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00202760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.