MEDICARE: AMIN PAKZAD DENTISTRY PLLC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1356146054
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMIN PAKZAD DENTISTRY PLLC

Provider Business Mailing Address
First Line	:	6216 WENTWORTH DR
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73025-2799
Country	:	US
Telephone Number	:	214-405-1935
Fax Number	:

Provider Business Practice Location Address
First Line	:	4440 NW EXPRESSWAY
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-1533
Country	:	US
Telephone Number	:	405-456-0610
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	AMIN PAKZAD
Credential	:	DDS
Telephone Number	:	214-405-1935

Provider Enumeration Date	:	02/17/2025
Last Update Date	:	02/17/2025

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