Azadeh Afzali D.D.S, INC.
Dentist, General Practice in San Bernardino, CA. Organization (NPI-2).
Details
- NPI
- 1669833810
- Entity type
- Organization (NPI-2)
- Legal business name
- Azadeh Afzali D.D.S, INC.
- Organization subpart
- No
- Enumeration date
- Mar 16, 2016
- Last updated
- Mar 16, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 55014 | CA | Yes |
| 122300000X | Dentist | 64657 | CA |
Other names
- Sb Lifetime Dental (Doing Business As)
Practice location
1918 Business Center Dr Ste 210San Bernardino, CA 92408-3441
Phone 909-881-3336 · Fax 909-890-9099
Mailing address
1918 Business Center Dr Ste 210San Bernardino, CA 92408-3441
Phone 909-881-3336 · Fax 909-890-9099
Authorized official
Azadeh Mary Afzali
President
9098813336
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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