Innovative Dental Group, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D008483 Issued in AZ

Legal business name

INNOVATIVE DENTAL GROUP, PLLC

Practice address

5209 N Oracle Rd
Tucson, AZ 85704-3707

Phone

(520) 293-9277

NPI assigned

Jan 30, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Payam Kimiaei-Asadi, DMD

Title

Dentist

Phone

(520) 293-9277

Specialties & licenses 1

Addresses

Other names 1

• Advanced Family Dentistry Doing business as

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

{
    "created_epoch": "1517270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785369600000",
    "number": "1639677115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5209 N ORACLE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857043707",
            "telephone_number": "520-293-9277",
            "fax_number": "520-293-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5209 N ORACLE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857043707",
            "telephone_number": "520-293-9277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE DENTAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-30",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A",
        "authorized_official_last_name": "KIMIAEI-ASADI",
        "authorized_official_first_name": "PAYAM",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "520-293-9277",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D008483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Tucson, AZ
• Providers in Tucson, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2026; 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.