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Active NPI 1881922193 Individual Practitioner Male Practitioner

Dr. Azaryas Tadiwos Mandefro , DMD

Dentist • Arnold, MO

Professional Overview & Biography Verified Profile Summary

Dr. Azaryas Mandefro, DMD is a registered healthcare professional specializing in Dentist in Arnold, MO. Practice services are available at 3850 JEFFCO BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3850 Jeffco Blvd

Arnold, MO 63010

Telephone 6363333304
Fax 6363333307
Associated Practice Facility / Clinic
🏢 Shawn Davaie Motlagh Dds Pc Facility NPI 1861882862

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Arnold, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 9.6 Yrs
Regional Practice Density
23 Specialists

Practicing in Arnold, MO (1740 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License MO 2009032198

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
40066124 (MO)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1477840205

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location May 06, 2025

Registered at 3850 JEFFCO BLVD, ARNOLD, MO 63010 (Tel: 6363333304)

📍
Updated Business Mailing Address May 06, 2025

Registered at 3850 JEFFCO BLVD, ARNOLD, MO 63010 (Tel: 6363333304)

NPI Profile Active April 21, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location April 21, 2011

Registered at 1708 MISSOURI STATE RD, ARNOLD, MO 630104603 (Tel: 6362879331)

📍
Updated Business Mailing Address April 21, 2011

Registered at 1708 MISSOURI STATE RD, ARNOLD, MO 630102006 (Tel: 6362879331)

👤
Provider Name / Credentials Updated April 21, 2011

Recorded as AZARYAS MANDEFRO, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 21, 2011

Dentist (License #2009032198 in MO)

🟢
Initial NPI Registration & Enumeration November 24, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1881922193
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 24, 2009
Last Update: May 06, 2025
Sole Proprietor: Yes

Mailing Address

3850 Jeffco Blvd

Arnold, MO 63010

Phone: 6363333304

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.