Active NPI
Roz Aghaaliandastjerdi, DMD
- Dentist
- Palm Coast, FL
National Provider Identifier
1427649755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN25014
- Practice address
- 4873 Belle Terre Pkwy
Palm Coast, FL 32137-8696 - Phone
- (386) 864-8313
- NPI assigned
- Jan 29, 2021
- Last updated
- Aug 18, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 36784 | TX | |
| Dentist | 122300000X | DN25014 | FL | Primary |
Addresses
Primary practice location
4873 Belle Terre Pkwy
Palm Coast, FL 32137-8696
Mailing address
12341 NW 26TH St
Plantation, FL 33323-1773
Phone (954) 218-9052
Other practice location 1
6940 Coit Rd Ste 200
Plano, TX 75023-1084
Phone (469) 290-3601
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN25014 | FL | MD | Dentist |
| 36784 | TX | MD | General Practice Dentistry |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629244800000",
"number": "1427649755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12341 NW 26TH ST",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333231773",
"telephone_number": "954-218-9052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4873 BELLE TERRE PKWY",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321378696",
"telephone_number": "386-864-8313"
}
],
"practiceLocations": [
{
"address_1": "6940 Coit Rd Ste 200",
"address_purpose": "LOCATION",
"city": "Plano",
"state": "TX",
"postal_code": "750231084",
"country_code": "US",
"telephone_number": "469-290-3601",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AGHAALIANDASTJERDI",
"first_name": "ROZ",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-29",
"last_updated": "2021-08-18",
"certification_date": "2021-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "36784",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN25014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Coast, FL
- Adventist Health System Sunbelt, Inc (AdventHealth Total Health Management DBA Primary Care Plus Palm Coast Seminole Woods)
- Adventist Health System/Sunbelt Inc. (AdventHealth Centra Care - Palm Coast)
- Advocacy Alliance, LLC
- Affordable Dentures & Implants - Palm Coast, P.a. (Affordable Dentures & Implants - Palm Coast)
- Affordable Health Center Inc (Palm Coast Integrated Pain & Rehab Center)
- Jennifer Marie Agosto, ACNPC-AG
- Sarai Aguiar Ugalde
- Tanam Ahmed, MD
- Oluwatosin Adesola Ajayi, SA-C ,IMG
- Alan Medina, MD PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.