Individual provider Active NPI

Ailar Bagherdaei

  • Prosthodontics
  • Englewood, CO
National Provider Identifier
1689112187
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DEN.00203254 Issued in CO
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

Updated by the provider on Jan 28, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
DS039513PAMDDentist
DEN.00203254COMDProsthodontist

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.

Verify at the official NPI Registry.