MEDICARE: HASSAN AZARPIRA DDS LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist		IL

General Provider Information

NPI Number	:	1265633895
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HASSAN AZARPIRA DDS LTD

Provider Business Mailing Address
First Line	:	PO BOX 23020
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-0020
Country	:	US
Telephone Number	:	773-522-5011
Fax Number	:	773-522-5096

Provider Business Practice Location Address
First Line	:	2709 S PULASKI RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-0020
Country	:	US
Telephone Number	:	773-522-5011
Fax Number	:	773-522-5096

Authorized Official
Title or Position	:	DENTIST PRESIDENT
Name	:	HASSAN AZARPIRA
Credential	:	DDS
Telephone Number	:	773-522-5011

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	08/22/2020

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