=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285428631
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MAZIN & NOOR DDS PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/08/2025
-----------------------------------------------------
Last Update Date | 04/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5940 W UNION HILLS DR STE F110
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85308-1304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 623-815-5701
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7254 W CRYSTAL RD
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85308-9584
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-772-9355
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER DOCTOR
-----------------------------------------------------
Name | MAZIN ALBAYATI
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 512-772-9355
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------