Mandana Mozayeni-Azar, D.D.S., M.S.D.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

49379 Issued in CA

Practice address

18 Coastal Oak
Newport Coast, CA 92657-1655

Phone

(216) 299-5223

NPI assigned

Feb 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1912970724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3189 LANDER RD",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "441245442",
            "telephone_number": "330-633-7076",
            "fax_number": "216-378-8964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 COASTAL OAK",
            "city": "NEWPORT COAST",
            "state": "CA",
            "postal_code": "926571655",
            "telephone_number": "216-299-5223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3189 Lander Rd",
            "address_purpose": "LOCATION",
            "city": "Pepper Pike",
            "state": "OH",
            "postal_code": "441245442",
            "country_code": "US",
            "telephone_number": "330-633-7076",
            "fax_number": "216-378-8964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOZAYENI-AZAR",
        "first_name": "MANDANA",
        "credential": "D.D.S., M.S.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "49379",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OH",
            "license": "21664",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "49379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Newport Coast, CA
• Providers in Newport Coast, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; 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.