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General NPI Number Information
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NPI Number | 1013359603
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Entity Type | Individual
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Provider Name | JOSEPH SADYKOV D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/23/2013
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Last Update Date | 10/03/2023
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Provider Practice Location Address
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Address Line | 1277 E MISSOURI AVE STE 202
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City | PHOENIX
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State | AZ
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Zip | 85014-2917
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Country | US
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Telephone | 236-238-9348
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Fax |
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Provider Business Mailing Address
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Address Line | 1545 E VILLA THERESA DR
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City | PHOENIX
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State | AZ
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Zip | 85022-1282
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Country | US
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Telephone | 917-468-8035
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | D009807
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License Number State | AZ
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