Dr. Edward Farajzadeh, dds
Dentist, Oral and Maxillofacial Surgery in Del Mar, CA. Individual provider (NPI-1).
NPI number1700895166
StatusActive
Last updated in NPPESOct 17, 2019
Details
- NPI
- 1700895166
- Entity type
- Individual (NPI-1)
- Name
- Dr. Edward Farajzadeh
- Credential
- dds
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 5, 2006
- Last updated
- Oct 17, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - ORAL SURGERY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- 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 |
|---|---|---|---|---|
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | 33031 | CA | Yes |
| 122300000X | Dentist | 33031 | CA |
Practice location
13983 Mango Dr Ste 106Del Mar, CA 92014-3146
Phone 858-792-6662 · Fax 858-792-0536
Mailing address
13983 Mango Dr Ste 106Del Mar, CA 92014-3146
Phone 858-792-6662 · Fax 858-792-0536
Other practice locations
12921 Pomerado Rd
Poway, CA 92064-5325
Poway, CA 92064-5325
Phone 858-679-4949
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Other Oral and Maxillofacial Surgery (Dentist) providers in Del Mar, CA
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