Individual provider Active NPI

Salar Azad, DDS

  • Periodontics
  • Frederick, MD
National Provider Identifier
1578092771
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
16369 Issued in MD
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

Updated by the provider on Jul 16, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 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

LicenseStateTypeSpecialty
DEN1002104DCMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Azad Dental Group General Practice CurrentSince Jul 12, 2020 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.

Verify at the official NPI Registry.