Azadeh Emam, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DN1855565 Issued in MA

Practice address

55 Sack Blvd
Unit 5
Leominster, MA 01453-3325

Phone

(978) 466-6800

Fax

(978) 466-6801

NPI assigned

May 19, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

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": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305763200000",
    "number": "1982997177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 SACK BLVD",
            "address_2": "UNIT 5",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014533325",
            "telephone_number": "857-277-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SACK BLVD",
            "address_2": "UNIT 5",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014533325",
            "telephone_number": "978-466-6800",
            "fax_number": "978-466-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMAM",
        "first_name": "AZADEH",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-19",
        "last_updated": "2011-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1855565",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019028489",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "0025956",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "10358",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011534A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Leominster, MA
• Providers in Leominster, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; 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.