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Provider Information for 1588950521



HALEH BAZARGAN DDS

Other Name:   HALEH BAZARGAN
Gender: FEMALE

Individual NPI: 1588950521

Calendar Last Updated: 2014-03-28

Details

Name Value
NPI 1588950521
Enumeration Date 2011-06-28
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 5544 E SHEENA DR
SCOTTSDALE, AZ 85254-2959
United States

Phone: 631-388-0906 | Fax:
View Map External Link
Primary Practice Address 430 W FINNIE FLAT RD
CAMP VERDE, AZ 86322-7362
United States

Phone: 631-388-0906 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID AZ 758643
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist AZ 8563