Neda Ensieh Delavari, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8667 Issued in AZ

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

Last updated

Aug 31, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Ensieh Delavari Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

• Familt& Esthetic Dentistry

  dba Lifetime smiles

  • Dental Clinic/Center
  • Glendale, AZ
  • NPI 1427414341
  Authorized official Same address or phone

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"
        }
    ]
}

• Del Anesthesia Services, LLC
• Dominic Del Boccio
• Del Healthcare LLC
• Nina Del Rosario, OTR/L
• Amy Jean Delano, PHARMD
• Leanna Marie Deleon, PT, DPT, MBA
• Luis Deleon, LCSW
• Kevin Delfino, MD
• Nicole Delia, DPT
• Daniel Justin Dellostritto

• General Practice Dentistry in Glendale, AZ
• Providers in Glendale, AZ by specialty
• General Practice Dentistry in Arizona

• 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.

Verify at the official NPI Registry.