Idin Zhalehdoust Sani, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DE60752640 Issued in WA

Practice address

18008 State Route 410 E Ste B
Bonney Lake, WA 98391-7113

Phone

(253) 826-5000

NPI assigned

Feb 17, 2016

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1455667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1720447865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18008 STATE ROUTE 410 E STE B",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983917113",
            "telephone_number": "253-826-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18008 STATE ROUTE 410 E STE B",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983917113",
            "telephone_number": "253-826-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 55th St",
            "address_2": "NYU Lutheran Medical Center, Dental Medicine",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112202508",
            "country_code": "US",
            "telephone_number": "718-630-8537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZHALEHDOUST SANI",
        "first_name": "IDIN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-17",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "059985",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE60752640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lenny Yann, PHARMD
• Michele Yi, MD
• Susan Y Yoon, PHARMD
• Brenda Ann Zak, LMP
• Zemla Family Corporation
• Paz Zisman, PT

• Pediatric Dentistry in Bonney Lake, WA
• Providers in Bonney Lake, WA by specialty
• Pediatric Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.