Provider Demographics
NPI:1376524942
Name:ABEDI, PAYAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAYAM
Middle Name:
Last Name:ABEDI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9746 N 90TH PL
Mailing Address - Street 2:#201
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5083
Mailing Address - Country:US
Mailing Address - Phone:480-614-8000
Mailing Address - Fax:480-614-3801
Practice Address - Street 1:9746 N 90TH PL
Practice Address - Street 2:#201
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5083
Practice Address - Country:US
Practice Address - Phone:480-614-8000
Practice Address - Fax:480-614-3801
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5414122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist