Maryland Garden Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

4954 Issued in AZ

Legal business name

MARYLAND GARDEN DENTAL

Practice address

650 W Maryland Ave
Suite 2
Phoenix, AZ 85013-1399

Phone

(602) 249-1616

Fax

(602) 249-1138

NPI assigned

May 11, 2007

Last updated

May 27, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Massoud Eftekhari, D.D.SNPI 1659524692

Title

Owner

Phone

(602) 249-1616

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Massoud Eftekhari, DDS

  • General Practice Dentistry
  • Cottonwood, AZ
  • NPI 1659524692
  NPD (past) Authorized official
• S Steven Podstreleny, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Poway, CA
  • NPI 1922188150
  NPD (past)

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1659586774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 W MARYLAND AVE",
            "address_2": "SUITE 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850131399",
            "telephone_number": "602-249-1616",
            "fax_number": "602-249-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 W MARYLAND AVE",
            "address_2": "SUITE 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850131399",
            "telephone_number": "602-249-1616",
            "fax_number": "602-249-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND GARDEN DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "EFTEKHARI",
        "authorized_official_first_name": "MASSOUD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-249-1616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AZ",
            "license": "4954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "169853",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH CHOICE",
            "identifier": "450966",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "16354",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HMO",
            "identifier": "250891",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Group Home LLC
• Mary Group Home LLC
• Mary Group Home LLC
• Mary Lynne Mack PHD LLC
• Maryland Avenue Periodontics, LLC
• Maryland Gardens SNF, LLC (Maryland Gardens Assisted Living)
• Maryland Gardens SNF, LLC (Maryland Gardens Post Acute)
• Don Andrew Maryon, MS, LAC
• Maryvale Cardiology PC
• Maryvale Children's Dentistry and Orthodontics PLLC (Maryvale Children's Dentistry)

• Dental Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dental Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; 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.