Provider Demographics
NPI:1417328733
Name:AKBARZADEH, NAVID (DMD, MSD)
Entity Type:Individual
Prefix:DR
First Name:NAVID
Middle Name:
Last Name:AKBARZADEH
Suffix:
Gender:M
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1790 MULKEY RD STE 2
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-1122
Mailing Address - Country:US
Mailing Address - Phone:770-800-5500
Mailing Address - Fax:
Practice Address - Street 1:1790 MULKEY RD STE 2
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1122
Practice Address - Country:US
Practice Address - Phone:770-800-5500
Practice Address - Fax:770-884-7979
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-13
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0250001223E0200X
GADN0151981223E0200X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics