Ebrahim H Baradaran, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

0401410423 Issued in VA

Practice address

100 W Main St
Berryville, VA 22611-1242

Phone

(804) 651-1515

Fax

(540) 955-4158

NPI assigned

Aug 14, 2007

Last updated

Aug 14, 2007By 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

Enrolled in VA

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

State licenses

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.

• Ebrahim H. Baradaran D.M.D. P.C.

  • Dentist
  • New Castle, VA
  • NPI 1073851960
  Authorized official Same address or phone

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187049600000",
    "number": "1477745396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W MAIN ST",
            "city": "BERRYVILLE",
            "state": "VA",
            "postal_code": "226111242",
            "telephone_number": "804-651-1515",
            "fax_number": "540-955-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W MAIN ST",
            "city": "BERRYVILLE",
            "state": "VA",
            "postal_code": "226111242",
            "telephone_number": "804-651-1515",
            "fax_number": "540-955-4158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARADARAN",
        "first_name": "EBRAHIM",
        "middle_name": "H",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-14",
        "last_updated": "2007-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401410423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Argyll Transport and Support Services, LLC (Argyll Transport)
• Shaileen Robin Backman, LCSW
• Samantha Jean Baerhardt, MS, LPC
• Amanda J Baltierra, FNP-BC
• Alicia Banks, OT
• Battletown Pharmacy, Inc. (Battletown Pharmacy)
• Samuel Bauman, PHD, LPC
• Behavioral Cusp
• Angela Renee Bell
• Berryville Medical Associates PLC

• Dentist in Berryville, VA
• Providers in Berryville, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.