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General NPI Number Information
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NPI Number | 1841776150
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Entity Type | Individual
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Provider Name | ARYAN FARBOD ABEDINI DMD
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Gender | Male
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Dates
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Enumeration Date | 07/19/2018
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Last Update Date | 07/18/2023
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Provider Practice Location Address
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Address Line | 12685 W INDIAN SCHOOL RD # 102
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City | AVONDALE
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State | AZ
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Zip | 85392-0001
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Country | US
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Telephone | 623-270-7420
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Fax | 623-270-7421
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Provider Business Mailing Address
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Address Line | NAVAL MEDICAL CENTER 34800 BOB WILSON DRIVE
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City | SAN DIEGO
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State | CA
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Zip | 92134-0001
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Country | US
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Telephone |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DDS102809
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D010480
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License Number State | AZ
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