Individual provider Active NPI

Shahin Madi, D.M.D., M.S.

  • Periodontics
  • Scottsdale, AZ
National Provider Identifier
1699980920
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
D7175 Issued in AZ
Practice address
23271 N Scottsdale Rd Ste A106
Scottsdale, AZ 85255-4484
Phone
(480) 544-2383
NPI assigned
May 11, 2007
Last updated
Apr 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 34761 TX
Periodontics 1223P0300X S4-83C NV
Periodontics 1223P0300X D7175 AZ Primary

Addresses

Primary practice location

23271 N Scottsdale Rd Ste A106
Scottsdale, AZ 85255-4484

Mailing address

8236 N 62ND PL
Paradise Valley, AZ 85253-2645
Phone (480) 215-2859

Other identifiers 1

IdentifierTypeStateIssuer
1699980920MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150820010336 CA Order and Referring Only - DentistPractitioner - Dentist 8426363433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
D7175AZMDPeriodontist
S4-83CNVMDPeriodontist
34761TXMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Sym PHX LLC CurrentSince Apr 20, 2025 Accepting new patients
Pinnacle Modern Dentistry, LLP PastSince Dec 5, 2021 Accepting new patients
Marketplace Smiles, LLP Past Accepting new patients

Organizations & group practices 3

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": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1699980920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8236 N 62ND PL",
            "city": "PARADISE VALLEY",
            "state": "AZ",
            "postal_code": "852532645",
            "telephone_number": "480-215-2859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23271 N SCOTTSDALE RD STE A106",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852554484",
            "telephone_number": "480-544-2383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADI",
        "first_name": "SHAHIN",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "34761",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NV",
            "license": "S4-83C",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "D7175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699980920",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.