Active NPI
Mojtaba G Radi, D.D.S.
- General Practice Dentistry
- Folsom, CA
National Provider Identifier
1013003235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 43066
- Practice address
- 309 Natoma St
Folsom, CA 95630-2619 - Phone
- (916) 985-3366
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 43066 | CA | Primary |
Addresses
Primary practice location
309 Natoma St
Folsom, CA 95630-2619
Mailing address
309 Natoma St
Folsom, CA 95630-2619
Phone (530) 400-2118
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160617001197 | CA | Order and Referring Only - Dentist | 7810288099 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013003235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 NATOMA ST",
"city": "FOLSOM",
"state": "CA",
"postal_code": "956302619",
"telephone_number": "530-400-2118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 NATOMA ST",
"city": "FOLSOM",
"state": "CA",
"postal_code": "956302619",
"telephone_number": "916-985-3366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADI",
"first_name": "MOJTABA",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "43066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Folsom, CA
- Eve H Quesada, LCSW
- Thalia Quesada
- Teresa Quintana
- Paola F Race, OT
- Elyse Radell
- Radiological Associates of Sacramento Medical Group
- Radiological Associates of Sacramento Medical Group Inc
- Radiological Associates of Sacramento Medical Group Inc
- Radiological Associates of Sacramento Medical Group Inc
- Sonya Raghavan, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.