Provider Demographics
NPI:1770150898
Name:NORTH SCOTTSDALE EYE CARE
Entity type:Organization
Organization Name:NORTH SCOTTSDALE EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KIYAVASH
Authorized Official - Middle Name:
Authorized Official - Last Name:TEBYANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:480-348-5655
Mailing Address - Street 1:23602 N 73RD PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6131
Mailing Address - Country:US
Mailing Address - Phone:480-348-5655
Mailing Address - Fax:
Practice Address - Street 1:15355 N NORTHSIGHT BLVD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2603
Practice Address - Country:US
Practice Address - Phone:480-348-5655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty