Individual provider Active NPI

Aleksandr Azbel, DDS

  • Dentist
  • Tamarac, FL
National Provider Identifier
1699829291
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN26161 Issued in FL
Practice address
4267 W Commercial Blvd
Tamarac, FL 33319-3305
Phone
(954) 677-3202
NPI assigned
Jan 22, 2007
Last updated
Sep 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN26161 FL Primary
General Practice Dentistry 1223G0001X 050148 NY

Addresses

Primary practice location

4267 W Commercial Blvd
Tamarac, FL 33319-3305

Mailing address

3411 Guider Ave # 2
Brooklyn, NY 11235-5235
Phone (917) 834-2219

Other practice location 1

6555 woodhaven blvd
Lucky Dental PC
Rego park, NY 11374
Phone (718) 897-0800

Other identifiers 1

IdentifierTypeStateIssuer
02333159MedicaidNY

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN26161FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Allure Dental PLLC Dentist PastSince Sep 12, 2021 Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1699829291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 GUIDER AVE # 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112355235",
            "telephone_number": "917-834-2219",
            "fax_number": "718-459-9509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4267 W COMMERCIAL BLVD",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333193305",
            "telephone_number": "954-677-3202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6555 woodhaven blvd",
            "address_2": "Lucky Dental PC",
            "address_purpose": "LOCATION",
            "city": "Rego park",
            "state": "NY",
            "postal_code": "11374",
            "country_code": "US",
            "telephone_number": "718-897-0800",
            "fax_number": "718-459-9509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AZBEL",
        "first_name": "ALEKSANDR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN26161",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "050148",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02333159",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamarac, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.