Healthcare Provider Details

I. General information

NPI: 1770185845
Provider Name (Legal Business Name): PARDIS SOLEIMANZADEH AZAR DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2020
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 N MOPAC EXPY STE 250
AUSTIN TX
78759-8959
US

IV. Provider business mailing address

7800 N MOPAC EXPY STE 250
AUSTIN TX
78759-8959
US

V. Phone/Fax

Practice location:
  • Phone: 512-345-9779
  • Fax:
Mailing address:
  • Phone: 512-345-9779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number38973
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: