Active NPI
Neda Ensieh Delavari, D.D.S.
- General Practice Dentistry
- Glendale, AZ
National Provider Identifier
1891920443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 8667
- Practice address
- 6666 W Peoria Ave Ste 117
Glendale, AZ 85302-7016 - Phone
- (623) 878-6000
- Fax
- (623) 773-2230
- NPI assigned
- May 27, 2009
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8667 | AZ | Primary |
Addresses
Primary practice location
6666 W Peoria Ave Ste 117
Glendale, AZ 85302-7016
Mailing address
6666 W Peoria Ave St#117
Glendale, AZ 85302
Phone (623) 878-6000
Other names 1
- Dr. Ensieh Delavari
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | lifetimesmilesinfo@gmail.com | Health Information Exchange (HIE) |
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 |
|---|---|---|---|
| 8667 | AZ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630368000000",
"number": "1891920443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6666 W PEORIA AVE ST#117",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "85302",
"telephone_number": "623-878-6000",
"fax_number": "623-773-2230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6666 W PEORIA AVE STE 117",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853027016",
"telephone_number": "623-878-6000",
"fax_number": "623-773-2230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELAVARI",
"first_name": "NEDA",
"middle_name": "ENSIEH",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-27",
"last_updated": "2021-08-31",
"certification_date": "2021-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "8667",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "lifetimesmilesinfo@gmail.com",
"affiliation": "N",
"endpointDescription": "To sent prescription",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "6666 W Peoria Ave Ste 117",
"city": "Glendale",
"state": "AZ",
"country_code": "US",
"postal_code": "853027016",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "ENSIEH",
"last_name": "DELAVARI",
"prefix": "DR.",
"credential": "D.D.S.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.