Provider Demographics
NPI:1386745719
Name:SCOTTSDALE COSMETIC DENTISTRY
Entity type:Organization
Organization Name:SCOTTSDALE COSMETIC DENTISTRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEDAYAT
Authorized Official - Middle Name:
Authorized Official - Last Name:HARSINI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-996-8700
Mailing Address - Street 1:122 SKYVIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823
Mailing Address - Country:US
Mailing Address - Phone:623-846-5555
Mailing Address - Fax:623-846-5419
Practice Address - Street 1:3202 E GREENWAY RD
Practice Address - Street 2:1287
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032
Practice Address - Country:US
Practice Address - Phone:602-996-8700
Practice Address - Fax:602-996-7420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty