Idriss Mobarak Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

17900 Issued in TX

Legal business name

IDRISS MOBARAK INC.

Doing business as

The Smile Designer

Practice address

7809 Louetta Rd
Spring, TX 77379-7007

Phone

(281) 257-8815

Fax

(281) 257-6267

NPI assigned

Apr 21, 2009

Organization subpart

Yes

Parent organization

IDRISS MOBARAK INC.As reported in NPPES

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

Authorized official

Name

Dr. Maisa Idriss, DMD

Title

Owner

Phone

(281) 257-8815

Specialties & licenses 5

Addresses

Other names 1

• The Smile Designer Doing business as

Part of

Idriss Mobarak Inc

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240272000000",
    "number": "1043454135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7809 LOUETTA RD",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773797007",
            "telephone_number": "281-257-8815",
            "fax_number": "281-257-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7809 LOUETTA RD",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773797007",
            "telephone_number": "281-257-8815",
            "fax_number": "281-257-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDRISS MOBARAK INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IDRISS MOBARAK INC.",
        "enumeration_date": "2009-04-21",
        "last_updated": "2009-04-21",
        "status": "A",
        "authorized_official_last_name": "IDRISS",
        "authorized_official_first_name": "MAISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-257-8815",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "17900",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "17900",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Smile Designer",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Spring, TX
• Providers in Spring, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; 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.