Afshin Azmoodeh, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20074 Issued in TX

Practice address

228 W Campbell Rd
Richardson, TX 75080-3512

Phone

(972) 644-3800

NPI assigned

Sep 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Canyon Creek Family Dentistry, P.a.

  • General Practice Dentistry
  • Richardson, TX
  • NPI 1659502730
  NPD (past) Authorized official

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871699488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 W CAMPBELL RD",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803512",
            "telephone_number": "972-644-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 W CAMPBELL RD",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750803512",
            "telephone_number": "972-644-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZMOODEH",
        "first_name": "AFSHIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Ayala
• Mohammed Azam, D.O.
• Azhala Medicare Transportation LLC
• Azhala Medicare Transportation LLC
• Syed Husain Aziz, MD
• Laila Azouggagh, PA-C
• B. H. Rehabilitation, Inc
• Jenny Ba
• Baai Iom PLLC
• Mary May Canete Babac

• General Practice Dentistry in Richardson, TX
• Providers in Richardson, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.