Active NPI
Salar Azad, DDS
- Periodontics
- Frederick, MD
National Provider Identifier
1578092771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 16369
- Practice address
- 1020 Mill Pond Rd
Frederick, MD 21701-9427 - Phone
- (240) 423-4243
- NPI assigned
- Jun 9, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DEN1002104 | DC | |
| Periodontics | 1223P0300X | 16369 | MD | Primary |
| General Practice Dentistry | 1223G0001X | 16369 | MD |
Addresses
Primary practice location
1020 Mill Pond Rd
Frederick, MD 21701-9427
Mailing address
1020 Mill Pond Rd Ste F
Frederick, MD 21701-9428
Phone (240) 423-4243
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 |
|---|---|---|---|
| DEN1002104 | DC | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Azad Dental Group | General Practice | Current | Accepting new patients |
| Elevation Dental LLC | Periodontics | Current | Accepting new patients |
Locations
1020 Mill Pond Rd
Ste F
Frederick, MD 21701
1020 Mill Pond Rd
Ste H
Frederick, MD 21701
Phone (301) 845-5400
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594857600000",
"number": "1578092771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 MILL POND RD STE F",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217019428",
"telephone_number": "240-423-4243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 MILL POND RD",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217019427",
"telephone_number": "240-423-4243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AZAD",
"first_name": "SALAR",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-09",
"last_updated": "2020-07-16",
"certification_date": "2020-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Periodontics",
"state": "DC",
"license": "DEN1002104",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MD",
"license": "16369",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "16369",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.