# DR. MASSOUD EFTEKHARI

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- **Entity:** Organization
- **Status:** Active
- **Other names:** VIP Family and Sedation Dentistry, PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528567575
- **Authorized official:** DR. MASSOUD EFTEKHARI DDS (DENTIST/OWNER)
- **Authorized official phone:** (602) 430-8462

## Contact information

- **Practice address:** 830 S MAIN ST STE 1D, COTTONWOOD, AZ 86326-4621
- **Practice address phone:** (928) 634-5566
- **Practice address fax:** (928) 634-5566
- **Mailing address:** 14524 N 106TH PL, SCOTTSDALE, AZ 85255-8595
- **Mailing address phone:** (602) 430-8462
- **Mailing address fax:** (928) 634-1363

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 4954 | AZ | Yes |

## Other

- **Enumeration date:** 02/05/2018
- **Last updated:** 02/05/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1659524692 | NPI INDIVIDUAL | AZ |
| 01 | — | 4954 | DENTAL LICENSE | AZ |
| 05 | — | 496932 | — | AZ |