Provider Demographics
NPI:1568144772
Name:ENDOARTAZ, PLLC
Entity Type:Organization
Organization Name:ENDOARTAZ, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SADYKOV
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-468-8035
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:602-297-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty