Provider Demographics
NPI:1891878765
Name:A&A FAMILY DENTISTRY
Entity Type:Organization
Organization Name:A&A FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ABEDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-218-2222
Mailing Address - Street 1:6040 N 43RD AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-5481
Mailing Address - Country:US
Mailing Address - Phone:623-218-2222
Mailing Address - Fax:623-218-2221
Practice Address - Street 1:6040 N 43RD AVE STE 4
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-5481
Practice Address - Country:US
Practice Address - Phone:623-218-2222
Practice Address - Fax:623-218-2221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD54141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty