Mohammad Moridnia, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

27064 Issued in TX

Practice address

3603 S. Front Street
Suite #107
Brookshire, TX 77423

Phone

(832) 279-8368

NPI assigned

Jul 7, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Networks

• TX HMO D-SNP
• NM HMO C-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Brookshire Smile, PA

  • Dentist
  • Brookshire, TX
  • NPI 1316371354
  NPD (past) Authorized official

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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "27064",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Brookshire, TX
• Providers in Brookshire, TX by specialty
• Dentist in Texas

• 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.

Verify at the official NPI Registry.