Active NPI
Milad Azadi, D.M.D.
- Dentist
- Philadelphia, PA
National Provider Identifier
1720329162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS039093
- Practice address
- 2979 W School House LN
Apt. K507A
Philadelphia, PA 19144-5401 - Phone
- (949) 378-8119
- NPI assigned
- Mar 11, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS039093 | PA | Primary |
| Dentist | 122300000X | 22DI02523800 | NJ |
Addresses
Primary practice location
2979 W School House LN
Apt. K507A
Philadelphia, PA 19144-5401
Mailing address
2979 W School House LN
Apt. K507A
Philadelphia, PA 19144-5401
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02523800 | NJ | MD | Dentist |
| DS039093 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362960000000",
"number": "1720329162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2979 W SCHOOL HOUSE LN",
"address_2": "APT. K507A",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191445401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2979 W SCHOOL HOUSE LN",
"address_2": "APT. K507A",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191445401",
"telephone_number": "949-378-8119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AZADI",
"first_name": "MILAD",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-03-11",
"last_updated": "2013-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS039093",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "22DI02523800",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.