Individual provider Active NPI

Parsa Owtad, DMD

  • Dentist
  • Peoria, AZ
National Provider Identifier
1538720024
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D010389 Issued in AZ
Practice address
13660 N 94TH Dr Ste E3
Peoria, AZ 85381-4209
Phone
(623) 974-4799
NPI assigned
Jun 25, 2019
Last updated
Jun 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D010389 AZ Primary

Addresses

Primary practice location

13660 N 94TH Dr Ste E3
Peoria, AZ 85381-4209

Mailing address

6975 E Princess Dr Apt 3049
Phoenix, AZ 85054-4231

Other practice location 1

4001 E Bell Rd Ste 120
Phoenix, AZ 85032-2242
Phone (602) 992-5600

Other practice location 2

13065 W McDowell Rd Ste 112
Avondale, AZ 85392-6439
Phone (623) 455-3600

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

LicenseStateTypeSpecialty
D010389AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Paradise Valley Family Dental LLC General Practice Past Accepting new patients
Ghasem K. Darian, D.D.S., LTD General Practice Past Accepting new patients

Organizations & group practices 2

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": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1538720024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6975 E PRINCESS DR APT 3049",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850544231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13660 N 94TH DR STE E3",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814209",
            "telephone_number": "623-974-4799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4001 E Bell Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850322242",
            "country_code": "US",
            "telephone_number": "602-992-5600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13065 W McDowell Rd Ste 112",
            "address_purpose": "LOCATION",
            "city": "Avondale",
            "state": "AZ",
            "postal_code": "853926439",
            "country_code": "US",
            "telephone_number": "623-455-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OWTAD",
        "first_name": "PARSA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-25",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D010389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; 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.