Azar Hosseini Dehkordi, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DE00007259 Issued in WA

Practice address

10564 5TH Ave NE
Suite 403
Seattle, WA 98125-7200

Phone

(206) 362-5355

Fax

(206) 361-0419

NPI assigned

Feb 23, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619003936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10564 5TH AVE NE",
            "address_2": "SUITE 403",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981257200",
            "telephone_number": "206-362-5355",
            "fax_number": "206-361-0419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10564 5TH AVE NE",
            "address_2": "SUITE 403",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981257200",
            "telephone_number": "206-362-5355",
            "fax_number": "206-361-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHKORDI",
        "first_name": "AZAR",
        "middle_name": "HOSSEINI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00007259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5021696",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alex John Degrave
• Joshua James Degrave, PHARMD
• Chantal J Degroat
• Kristin Lee Degroot, PA-C
• Richard Emil Dehenes, L.M.H.C.
• Nicholas T Dehmer
• Rebecca Anne Dehnel, MD
• Rebecca Leigh Dehority, MD
• Michelle Mentzer Deiner
• Lauren Michelle Deiparine, DPT

• Dentist in Seattle, WA
• Providers in Seattle, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.