Provider Demographics
NPI:1982871596
Name:ESBAH, ROZITA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROZITA
Middle Name:
Last Name:ESBAH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ROZITA
Other - Middle Name:
Other - Last Name:ESBAH-TABATABAIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:76 E BILTMORE ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016
Mailing Address - Country:US
Mailing Address - Phone:602-595-7180
Mailing Address - Fax:
Practice Address - Street 1:14201 N HAYDEN RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2931
Practice Address - Country:US
Practice Address - Phone:480-998-4867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ74821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice