Individual provider Active NPI

Morris Azad, DDS

  • Dentist
  • San Fernando, CA
National Provider Identifier
1992886279
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
39932 Issued in CA
Practice address
1104 San Fernando Rd
San Fernando, CA 91340-3210
Phone
(818) 361-6900
Fax
(818) 837-8569
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 39932 CA Primary

Addresses

Primary practice location

1104 San Fernando Rd
San Fernando, CA 91340-3210

Mailing address

1104 San Fernando Rd
San Fernando, CA 91340-3210
Phone (818) 361-6900

Other identifiers 1

IdentifierTypeStateIssuer
B39932MedicaidCA

Other names 1

  • Dr. Morris Akhamzadeh Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20190409002656 CA Practitioner - Oral SurgeryPractitioner - Dentist 2860797370 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Morris Azad DDS Inc. Dentist CurrentSince Dec 1, 2018 Accepting new patients

Locations

1104 San Fernando Rd
San Fernando, CA 91340
Phone (818) 361-6900

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1992886279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 SAN FERNANDO RD",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913403210",
            "telephone_number": "818-361-6900",
            "fax_number": "818-837-8569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 SAN FERNANDO RD",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913403210",
            "telephone_number": "818-361-6900",
            "fax_number": "818-837-8569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZAD",
        "first_name": "MORRIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "39932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B39932",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MORRIS",
            "last_name": "AKHAMZADEH",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Fernando, CA

Sources for this page

Verify at the official NPI Registry.