MEDICARE: SAUM DEHLEH HOSSEIN ZADEH

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	1223G0001X	General Practice Dentistry	D012622	AZ

General Provider Information

NPI Number	:	1902786254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAUM DEHLEH HOSSEIN ZADEH

Provider Business Mailing Address
First Line	:	4317 E MCDOWELL RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85008-4501
Country	:	US
Telephone Number	:	530-848-5232
Fax Number	:

Provider Business Practice Location Address
First Line	:	4317 E MCDOWELL RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85008-4501
Country	:	US
Telephone Number	:	530-848-5232
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2025
Last Update Date	:	09/06/2025

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