MAZDENTA ADVANCED DENTISTRY PLLC – NPI #1790668770
Clinic/Center

MAZDENTA ADVANCED DENTISTRY PLLC is an AHC clinic located in BOURNE, MA. NPPES has assigned the NPI number 1790668770 to MAZDENTA ADVANCED DENTISTRY PLLC on July 28, 2025. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MAZDENTA ADVANCED DENTISTRY PLLC below.

NPI Profile for
MAZDENTA ADVANCED DENTISTRY PLLC

NPI Number
1790668770
Enumeration Date

(about 10 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MAZDENTA ADVANCED DENTISTRY PLLC
Primary location
1 TROWBRIDGE RD STE 7
BOURNE, MA 02532-3662
Phone: (508) 759-7200 Fax:
Mailing address
12 JEREMIAH CIR
MEDFORD, MA 02155-1676
Phone: (857) 250-1515 Fax:
Organization Subpart
No
Authorized Official
KHOSROW DINYARYAN
DMD
Phone: (857) 250-1515
Updated
Certification Date
Jul 28, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.