Provider Demographics
NPI:1013359603
Name:SADYKOV, JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:SADYKOV
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:IOSEF
Other - Middle Name:
Other - Last Name:SADYKOV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1545 E VILLA THERESA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-1282
Mailing Address - Country:US
Mailing Address - Phone:917-468-8035
Mailing Address - Fax:
Practice Address - Street 1:1277 E MISSOURI AVE STE 202
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2917
Practice Address - Country:US
Practice Address - Phone:236-238-9348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0098071223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics