Dr Azizi Pllc | |
1538 11th Ave Longview WA 98632-4123 | |
(323) 804-1324 | |
Not Available |
Full Name | Dr Azizi Pllc |
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Speciality | Dentist |
Location | 1538 11th Ave, Longview, Washington |
Authorized Official Name and Position | Hamid Azizi (OWNER) |
Authorized Official Contact | 3238041324 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dr Azizi Pllc 3984 Nw Currawong Ct Camas WA 98607-8521 Ph: () - | Dr Azizi Pllc 1538 11th Ave Longview WA 98632-4123 Ph: (323) 804-1324 |
NPI Number | 1275259582 |
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Provider Enumeration Date | 10/18/2022 |
Last Update Date | 10/18/2022 |
Medicare PECOS PAC ID | 4981071727 |
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Medicare Enrollment ID | O20221107003222 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275259582 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
Provider Name | Hamid Azizi |
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Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1598200610 PECOS PAC ID: 5890162630 Enrollment ID: I20221107003237 |
Matthew E Lesh Dmd Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 950 14th Ave, Longview, WA 98632 Phone: 360-200-4924 | |