Edward Farajzadeh, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

33031 Issued in CA

Practice address

13983 Mango Dr Ste 106
Del Mar, CA 92014-3146

Phone

(858) 792-6662

Fax

(858) 792-0536

NPI assigned

Aug 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Edward Farajzadeh, DDS Apdc

  • Dental Clinic/Center
  • Del Mar, CA
  • NPI 1952872517

  Dentist

  NPD Authorized official

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1700895166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13983 MANGO DR STE 106",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920143146",
            "telephone_number": "858-792-6662",
            "fax_number": "858-792-0536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13983 MANGO DR STE 106",
            "city": "DEL MAR",
            "state": "CA",
            "postal_code": "920143146",
            "telephone_number": "858-792-6662",
            "fax_number": "858-792-0536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12921 Pomerado Rd",
            "address_purpose": "LOCATION",
            "city": "Poway",
            "state": "CA",
            "postal_code": "920645325",
            "country_code": "US",
            "telephone_number": "858-679-4949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARAJZADEH",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "33031",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "33031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra G Evans, MFTC
• Stephanie Sullivan Evans, LMFT
• Evolve Growth Initiatives LLC
• Bettina Experton, M.D.
• Lucinda Evans Faison-Olsen, MFT
• Andrew Joseph Fasciani, O.D.
• Jamie Marc Ferguson, DDS
• Katie Fermanian
• Kevin Thomas Fitzpatrick, D.D.S., M.S.
• Hattie Fleming, OTD

• Oral and Maxillofacial Surgery (Dentist) in Del Mar, CA
• Providers in Del Mar, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.