Active NPI
Mohammad Moridnia, D.D.S
- Dentist
- Brookshire, TX
National Provider Identifier
1003103326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 27064
- Practice address
- 3603 S. Front Street
Suite #107
Brookshire, TX 77423 - Phone
- (832) 279-8368
- NPI assigned
- Jul 7, 2011
- Last updated
- Aug 8, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 27064 | TX | Primary |
Addresses
Primary practice location
3603 S. Front Street
Suite #107
Brookshire, TX 77423
Mailing address
3603 S. Front Street
Suite # 107
Brookshire, TX 77423
Phone (713) 730-9294
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27064 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brookshire Smile, PA | Dentist | Past | Accepting new patients |
Networks
- TX HMO D-SNP
- NM HMO C-SNP
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375920000000",
"number": "1003103326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3603 S. FRONT STREET",
"address_2": "SUITE # 107",
"city": "BROOKSHIRE",
"state": "TX",
"postal_code": "77423",
"telephone_number": "713-730-9294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3603 S. FRONT STREET",
"address_2": "SUITE #107",
"city": "BROOKSHIRE",
"state": "TX",
"postal_code": "77423",
"telephone_number": "832-279-8368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORIDNIA",
"first_name": "MOHAMMAD",
"name_prefix": "Mr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-07",
"last_updated": "2013-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "27064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookshire, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.