Azaryas Tadiwos Mandefro is a Arnold, Missouri based Dentist who is specialized in
Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Azaryas Tadiwos Mandefro is
2009032198 for Dentistry in Missouri. His current practice location is
3850 Jeffco Blvd, Arnold. Patients can reach him at
636-333-3304.
Azaryas Tadiwos Mandefro is the primary dental care provider for patients of all ages. He is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Azaryas Tadiwos Mandefro speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Azaryas Tadiwos Mandefro |
| Specialization: | Dentist |
| Gender: | Male |
| Credentials: | DMD |
| Accepts Medicare Assignment: | No |
| Practice Address: | 3850 Jeffco Blvd, Arnold,
Missouri, 63010 |
| Phone: | 636-333-3304 |
| Fax: | 636-333-3307 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1881922193 |
| NPI Enumeration Date: | 24 Nov, 2009 |
| NPI Last Update On: | 06 May, 2025 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Azaryas Tadiwos Mandefro are as mentioned below.
| License Number | Specialization | State | Status | |
| 2009032198 | Dentistry | Missouri | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Azaryas Tadiwos Mandefro such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 40066124 | Medicaid | Missouri | |
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 3850 Jeffco Blvd,
Arnold, Missouri |
| Zip: | 63010 |
| Phone Number: | 636-333-3304 |
| Fax Number: | 636-333-3307 |
Patients can reach Azaryas Tadiwos Mandefro at
3850 Jeffco Blvd, Arnold, Missouri or can
call to book an appointment on 636-333-3304.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.