Active NPI
Ailar Bagherdaei
- Prosthodontics
- Englewood, CO
National Provider Identifier
1689112187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- DEN.00203254
- Practice address
- 5120 S Broadway Ste B
Englewood, CO 80113-9304 - Phone
- (303) 794-0044
- NPI assigned
- Feb 3, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS039513 | PA | |
| Prosthodontics | 1223P0700X | DEN.00203254 | CO | Primary |
| Prosthodontics | 1223P0700X | NA | CA |
Addresses
Primary practice location
5120 S Broadway Ste B
Englewood, CO 80113-9304
Mailing address
9339 Genesee Ave Ste 150
San Diego, CA 92121-2144
Phone (619) 837-2710
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 |
|---|---|---|---|
| DS039513 | PA | MD | Dentist |
| DEN.00203254 | CO | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769558400000",
"number": "1689112187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9339 GENESEE AVE STE 150",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921212144",
"telephone_number": "619-837-2710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5120 S BROADWAY STE B",
"city": "ENGLEWOOD",
"state": "CO",
"postal_code": "801139304",
"telephone_number": "303-794-0044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAGHERDAEI",
"first_name": "AILAR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-03",
"last_updated": "2026-01-28",
"certification_date": "2026-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS039513",
"primary": false
},
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "CO",
"license": "DEN.00203254",
"primary": true
},
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "CA",
"license": "NA",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Englewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.