Active NPI
Bashar Azar, DDS
- Dentist
- San Jose, CA
National Provider Identifier
1659718542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 45090
- Practice address
- 4110 Moorpark Ave Ste F
San Jose, CA 95117-1712 - Phone
- (408) 774-0555
- Fax
- (408) 774-9555
- NPI assigned
- May 31, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 45090 | CA | Primary |
Addresses
Primary practice location
4110 Moorpark Ave Ste F
San Jose, CA 95117-1712
Mailing address
4110 Moorpark Ave Ste F
San Jose, CA 95117-1712
Phone (408) 774-0555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 45090 | Other | CA | DENTIST LICENCE |
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 |
|---|---|---|---|
| 45090 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670457600000",
"number": "1659718542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4110 MOORPARK AVE STE F",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951171712",
"telephone_number": "408-774-0555",
"fax_number": "408-774-9555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4110 MOORPARK AVE STE F",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951171712",
"telephone_number": "408-774-0555",
"fax_number": "408-774-9555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AZAR",
"first_name": "BASHAR",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-31",
"last_updated": "2022-12-08",
"certification_date": "2022-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "45090",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTIST LICENCE",
"identifier": "45090",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.