Healthcare Provider Details

I. General information

NPI: 1730721978
Provider Name (Legal Business Name): AZIN PARSA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2019
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 W BALTIMORE ST RM 5201
BALTIMORE MD
21201-1510
US

IV. Provider business mailing address

650 W BALTIMORE ST RM 5201
BALTIMORE MD
21201-1510
US

V. Phone/Fax

Practice location:
  • Phone: 410-706-5264
  • Fax: 410-706-3965
Mailing address:
  • Phone: 410-706-5264
  • Fax: 410-706-3965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0008X
TaxonomyOral and Maxillofacial Radiology Dentistry
License Number151260
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1223X0008X
TaxonomyOral and Maxillofacial Radiology Dentistry
License NumberLL914
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: