DR. ABTIN ETEZADI-TABRIZI DMD
NPI 1366601866
Dentist - Oral and Maxillofacial Surgery in Sioux Falls, SD

Q: What is Abtin Etezadi-tabrizi's NPI number?

The NPI number for Abtin Etezadi-tabrizi is 1366601866. It was assigned to this individual provider in the NPPES registry on June 9, 2008.

Q: What is Abtin Etezadi-tabrizi's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Q: Is Abtin Etezadi-tabrizi enrolled in Medicare?

No. Abtin Etezadi-tabrizi has opted out of Medicare through March 5, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Active since June 09, 2008Opted out of Medicare · through Mar 5, 2028

1700 S SOUTHEASTERN AVE, SIOUX FALLS, SD 57103(605) 331-5059(605) 275-6725 Get Directions Write a Review

NPPES record last updated: April 14, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 14, 2026, Sep 6, 2018 (2 updates tracked since 2018).

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About Dr. Abtin Etezadi-tabrizi Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ABTIN ETEZADI-TABRIZI DMD (NPI 1366601866) is an individual oral and maxillofacial surgery provider in Sioux Falls, South Dakota, licensed in South Dakota (D1506) and active in the NPI registry since June 2008. He has opted out of Medicare through March 5, 2028 and remains eligible to order and refer and is a graduate of Medical College Of Georgia School Of Medicine (2008).

NPPES Registry Identity

NPI1366601866

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameDR. ABTIN ETEZADI-TABRIZICredential: DMD

Location Address1700 S SOUTHEASTERN AVESioux Falls, SD 57103-3227

Mailing Address1700 S Southeastern AveSioux Falls, SD 57103-3227 · (605) 331-5059 · Fax (605) 275-6725

Phone(605) 331-5059

Fax(605) 275-6725

Sole ProprietorNo

Medical School CMSMedical College Of Georgia School Of MedicineGraduated 2008

Enumeration DateJune 9, 2008

Last NPPES UpdateApril 14, 20262 updates tracked since enumeration

NPPES CertifiedApril 14, 2026

✔ NPI 1366601866 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in SD · D1506

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

1700 S SOUTHEASTERN AVE, Sioux Falls, SD 57103

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Abtin Etezadi-tabrizi Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 5, 2026 through March 5, 2028.

Opt-Out Effective DateMarch 5, 2026

Opt-Out In Effect ThroughMarch 5, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 57103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.21 typical visit price

range $55.52 – $167.23

Typical copayment $21.30 (range $13.88 – $41.80)

Most-billed visit code 99203

Established Patient

$69.20 typical visit price

range $18.08 – $137.08

Typical copayment $17.30 (range $4.52 – $34.27)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RIVER RIDGE ORAL & MAXILLOFACIAL SURGICAL CENTER

Dentist (Oral and Maxillofacial Surgery)

1700 S SOUTHEASTERN AVE
SIOUX FALLS, SD 57103

Minnehaha County (605) 331-5059

TREVOR HOLLEMAN DDS

Dentist (Oral and Maxillofacial Surgery)

1700 S SOUTHEASTERN AVE
SIOUX FALLS, SD 57103

Minnehaha County (605) 331-5059

DR. ANDREW C HILLE DMD

Dentist (Oral and Maxillofacial Surgery)

1700 S SOUTHEASTERN AVE
SIOUX FALLS, SD 57103

Minnehaha County (605) 331-5059

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Abtin Etezadi-tabrizi's NPI number?

The NPI number for Abtin Etezadi-tabrizi is 1366601866. It was assigned to this individual provider in the NPPES registry on June 9, 2008.

Where is Abtin Etezadi-tabrizi located?

Abtin Etezadi-tabrizi practices at 1700 S Southeastern Ave, Sioux Falls, SD 57103. The listed phone number is (605) 331-5059.

What is Abtin Etezadi-tabrizi's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Abtin Etezadi-tabrizi enrolled in Medicare?

No. Abtin Etezadi-tabrizi has opted out of Medicare through March 5, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Abtin Etezadi-tabrizi accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Florida Combined Life and 4 other insurers list Abtin Etezadi-tabrizi as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Abtin Etezadi-tabrizi was last updated on April 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.