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: 10/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5411-H KOURY ORAL HEALTH SCIENCES BUILDING
CHAPEL HILL NC
27599-7450
US

IV. Provider business mailing address

1114 SALUDA CT
CHAPEL HILL NC
27514-1688
US

V. Phone/Fax

Practice location:
  • Phone: 919-537-3162
  • Fax: 919-966-0705
Mailing address:
  • Phone: 919-338-9633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0008X
TaxonomyOral and Maxillofacial Radiology Dentistry
License Number151260
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: