Healthcare Provider Details

I. General information

NPI: 1588077812
Provider Name (Legal Business Name): FERHAN AZIZ D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2014
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1728 DUNLAWTON AVE STE 3
PORT ORANGE FL
32127-2923
US

IV. Provider business mailing address

1728 DUNLAWTON AVE STE 3
PORT ORANGE FL
32127-2923
US

V. Phone/Fax

Practice location:
  • Phone: 386-675-0088
  • Fax:
Mailing address:
  • Phone: 386-675-0088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN24602
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: