Provider Demographics
NPI:1871725275
Name:ESKANDARI, ASHKAN (DMD)
Entity type:Individual
Prefix:DR
First Name:ASHKAN
Middle Name:
Last Name:ESKANDARI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 W BASELINE RD
Mailing Address - Street 2:SUITE 176
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85041-6574
Mailing Address - Country:US
Mailing Address - Phone:602-507-6580
Mailing Address - Fax:602-507-6582
Practice Address - Street 1:2030 W BASELINE RD
Practice Address - Street 2:SUITE 176
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-6574
Practice Address - Country:US
Practice Address - Phone:602-507-6580
Practice Address - Fax:602-507-6582
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-18
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD78711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice