Ramesh Izedian DMD & Shohram Moghaddam DMD PC

Primary specialty

DentistTaxonomy code 122300000X

License

18174 Issued in MA

Legal business name

RAMESH IZEDIAN DMD & SHOHRAM MOGHADDAM DMD PC

Doing business as

Cosmetic Dental Associates

Practice address

3 Woodland Rd
Ste 417
Stoneham, MA 02180

Phone

(781) 662-1999

Fax

(781) 662-4430

NPI assigned

Nov 8, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Ramesh Izedian, DMD

Title

Owner

Phone

(781) 662-1999

Specialties & licenses 2

Addresses

Other names 1

• Cosmetic Dental Associates Doing business as

Locations

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720158942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WOODLAND RD",
            "address_2": "STE 417",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "02180",
            "telephone_number": "781-662-1999",
            "fax_number": "781-662-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WOODLAND RD",
            "address_2": "STE 417",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "02180",
            "telephone_number": "781-662-1999",
            "fax_number": "781-662-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAMESH IZEDIAN DMD & SHOHRAM MOGHADDAM DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "IZEDIAN",
        "authorized_official_first_name": "RAMESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-662-1999",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "18174",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "18767",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cosmetic Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kerry Prifti, PT
• Ann H Purdy, LICSW
• Sara Elizabeth Putnam
• Khether Raby, MD
• Stephanie Racine
• Jose Ramos
• Sharon Randle
• Lindsay Raymond
• Sally Reagan
• Toni - Ann T Rebelo, MSN, ANP

• Dentist in Stoneham, MA
• Providers in Stoneham, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.