DR. MASOUD EGHTEDARI (NPI# 1982676508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982676508 |
| Entity Type | Individual |
| Full Name | DR. MASOUD EGHTEDARI |
| Credential | DDS |
| Practice Address |
Bldg H 2005 Knight Lane Navy Medicine Support Command Attn: Medical Staff Svcs Jacksonville FL 32212-0140 |
| Mailing Address |
Psc 819 Box18-328 Fpo Ae SPAIN 09645 ES |
| Practice Telephone | 8585774725 |
| Mailing Telephone | 01134956823768 |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2009-02-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
4777 | LA | Dental Providers |
| Street Address |
BLDG H 2005 KNIGHT LANE NAVY MEDICINE SUPPORT COMMAND ATTN: MEDICAL STAFF SVCS |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32212-0140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811980550 | Richard Conway | Dentist | Bldg H 2005 Knight Lane, Navy Medicine Support Command Attn: Medical Staff Svcs, Jacksonville, FL 32212-0140 | 2005-08-29 |
| 1669023032 | Alek Montgomery | Dentist | Bldg H 2005 Knight Lane, Jacksonville, FL 32212-0140 | 2019-09-26 |
| 1134788615 | Hannah Yuni Chung | Dentist | Bldg H 2005 Knight Lane, Jacksonville, FL 32212-0140 | 2019-06-10 |
| 1073008819 | Rachel Alexandra Kurcz | Dentist | Bldg H 2005 Knight Lane, Jacksonville, FL 32212-0140 | 2018-06-25 |
| 1346768231 | Stephan Sidney Barrington | Dentist | Bldg H 2005 Knight Lane, Navy Medicine Support Command Attn: Medical Staff Svcs, Jacksonville, FL 32212-0140 | 2017-08-31 |
| 1154842797 | Tae Yung Kim | Dentist | Bldg H 2005 Knight Lane, Navy Medicine Support Command Attn: Medical Staff Svcs, Jacksonville, FL 32212 | 2017-07-05 |
| 1528519147 | Conrad Chou | Dentist | Bldg H 2005 Knight Lane, Navy Medicine Support Command Attn: Medical Staff Svcs, Jacksonville, FL 32212-0140 | 2016-10-19 |
| 1730636903 | Us Navy | Clinic/Center | Bldg H 2005 Knight Lane, Navy Medicine Support Command Attn: Medical Staff Svcs, Jacksonville, FL 32212-0140 | 2016-09-06 |
| 1760834980 | United Stated Navy | Dentist | Bldg H 2005 Knight Lane, Navy Medicine Support Support Command Attn: Medical Sta, Jacksonville, FL 32212-0140 | 2016-07-12 |
| 1003285453 | Anthony James Marin | Dentist | Bldg H 2005 Knight Lane, Navy Medicine Support Command Attn: Medical Staff Svcs, Jacksonville, FL 32212-0140 | 2015-09-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952911752 | Jeff Woohyeok Chang | Dentist | 964 Ajax Street, Jacksonville, FL 32212 | 2020-08-06 |
| 1518484427 | Amy Kathryn Lee | Student in an Organized Health Care Education/Training Program | Bumed, Centralized Credential & Privileging Directorate, 554 Keily Street, Jacksonville, FL 32212 | 2017-08-23 |
| 1659827970 | Noah Fixelle | Dentist | Bureau of Med and Surg Ccpd, 554 Keily Street, Jacksonville, VA 32212 | 2016-08-28 |
| 1972953339 | Colin Kenneth Kelly | General Practice | Bureau of Medicine & Surgery Detachment, Nas Jacksonville, Building 554, Jacksonville, FL 32212 | 2016-06-16 |
| 1912382359 | Caitlyn Brooke Hoysock | Dentist | 554 Keiley Street, Bureau of Medicine and Surgery - Credentials, Jacksonville, FL 32212 | 2015-07-28 |
| 1285017418 | John Alexander Ruch | Dentist | 554 Keily Street Bureau of Med and Surg Ccpd, Jacksonville, FL 32212 | 2015-07-07 |
| 1407238561 | Amanda Mona Lau | Student in an Organized Health Care Education/Training Program | 554 Kelly Street, Attn Centralized Credentialing, Bureau of Medicine and Surgery, Jacksonville, FL 32212 | 2015-06-25 |
| 1063894715 | Heather Dehaan | Family Medicine | 554 Kelly Street Bureau of Medicine and Surgery, Attention: Centralized Credentialing & Privileging Dire, Jacksonville, FL 32212 | 2015-06-18 |
| 1912389677 | Catherine Garcia | Student in an Organized Health Care Education/Training Program | 554 Kelly St, Credentialing & Privileging Directorate, Bureau of Medicine & Surgery, Attention: Centralized, Jacksonville, FL 32212 | 2015-06-18 |
| 1255712675 | James Robert Benson | Dentist | 734 Keily Street, Bumed, Jacksonville, FL 32212 | 2015-06-11 |
| Find all providers in zip 32212 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932728078 | Mohammad Reza Azari Samani | Dentist | 14453 Beach Blvd Ste 100, Jacksonville, FL 32250-2081 | 2020-04-09 |
| 1215390216 | Noel Rodriguez | Dentist | Naval Branch Health Clinic Nas Jax, Bldg 9 64, Birmingham Ave., Jacksonville, FL 32214-0001 | 2016-03-29 |
| 1588871289 | William Raymond Gielincki Jr. | Dentist | 6855 Belfort Oaks Pl, Jacksonville, FL 32216-6242 | 2007-05-16 |
| 1114059201 | Reza Azari Samani, Dds Pa | Dentist | 14453 Beach Blvd., Suite 100, Jacksonville, FL 32250 | 2007-03-12 |
| 1215951132 | Donald L. Smitha | Dentist | 812 Alderman Rd, Jacksonville, FL 32211-6102 | 2006-07-26 |
| 1083678262 | Eric M Olson | Dentist | 2078 Rogero Rd, Jacksonville, FL 32211-4119 | 2006-04-14 |
| 1023013281 | Wayne S. Barker | Dentist | 7740 Point Meadows Dr, Ste 4, Jacksonville, FL 32256-9180 | 2005-06-15 |
| 1265958128 | Diana Cole | Dentist | 554 Keily Street, Jacksonville, FL 32212 | 2017-08-22 |
| 1629449186 | Samuel Richards | Dentist | 554 Keily Street, Bur of Med & Surg Cred & Priv Division, Jacksonville, FL 23324 | 2015-10-09 |
| 1033528724 | Joseph Jarman | Dentist | 2005 Knight Lane Bldg H, Navy Medicine Support Command Attn: Medical Staff Svcs, Jacksonville, FL 32212-0140 | 2014-08-06 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32212 |
Please comment or provide details below to improve the information on DR. MASOUD EGHTEDARI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.