Active NPI
Aisan Eskandari-Yaghbastlo
- Dentist
- Saint Paul, MN
National Provider Identifier
1851281760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D15355
- Practice address
- 450 Syndicate St N
Saint Paul, MN 55104-4107 - Phone
- (651) 254-7373
- NPI assigned
- Jul 3, 2025
- Last updated
- Jul 3, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D15355 | MN | Primary |
Addresses
Primary practice location
450 Syndicate St N
Saint Paul, MN 55104-4107
Mailing address
111 Kellogg Blvd E
Saint Paul, MN 55101-1237
Phone (909) 649-8636
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250714003705 | MN | Order and Referring Only - Dentist | 6901311406 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1751500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751500800000",
"number": "1851281760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 KELLOGG BLVD E",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551011237",
"telephone_number": "909-649-8636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 SYNDICATE ST N",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551044107",
"telephone_number": "651-254-7373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESKANDARI-YAGHBASTLO",
"first_name": "AISAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-07-03",
"last_updated": "2025-07-03",
"certification_date": "2025-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D15355",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2025; 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.