Active NPI
Nader Azizi, DDS
- Endodontics
- Huntington, NY
National Provider Identifier
1851521900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 46455
- Practice address
- 124 Main St Ste 4
Huntington, NY 11743 - Phone
- (631) 417-3636
- NPI assigned
- Jul 23, 2009
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 054668 | NY | |
| Endodontics | 1223E0200X | 46455 | CA | Primary |
Addresses
Primary practice location
124 Main St Ste 4
Huntington, NY 11743
Mailing address
124 Main St Ste 4
Huntington, NY 11743-6922
Phone (631) 417-3636
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 |
|---|---|---|---|
| 46455 | CA | MD | Endodontist |
| 054668 | NY | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531872000000",
"number": "1851521900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 MAIN ST STE 4",
"city": "HUNTINGTON",
"state": "NY",
"postal_code": "117436922",
"telephone_number": "631-417-3636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 MAIN ST STE 4",
"city": "HUNTINGTON",
"state": "NY",
"postal_code": "11743",
"telephone_number": "631-417-3636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AZIZI",
"first_name": "NADER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-23",
"last_updated": "2018-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "NY",
"license": "054668",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CA",
"license": "46455",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.