Masoud Shoukoohi, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

11265 Issued in GA

Practice address

99 Mockingbird Dr
Cartersville, GA 30120-2826

Phone

(770) 386-3908

Fax

(770) 386-9986

NPI assigned

Jan 21, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• 99 Mockingbird Dental LLC

  • General Practice Dentistry
  • Cartersville, GA
  • NPI 1265259659
  NPD (past)
• Mockingbird Dental Associates

  • General Practice Dentistry
  • Cartersville, GA
  • NPI 1457810129
  NPD (past)

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

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232496000000",
    "number": "1063659571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 MOCKINGBIRD DR",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202826",
            "telephone_number": "770-386-3908",
            "fax_number": "770-386-9986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 MOCKINGBIRD DR",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202826",
            "telephone_number": "770-386-3908",
            "fax_number": "770-386-9986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOUKOOHI",
        "first_name": "MASOUD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-21",
        "last_updated": "2009-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "11265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Shields
• Shift Mobile Therapy and Wellness, LLC
• Anne L Shimsky, LPC
• Erica Eunseo Shin, OD
• Hamid Redha Shirazi
• Julie Goulding Shrewsbury, NP-C
• Charles Jeffrey Sidlow, D.P.M.
• Daryl Silver, RN
• Carlee Elizabeth Silvers, RBT
• Melanie Silvers, OTR/L

• Dentist in Cartersville, GA
• Providers in Cartersville, GA by specialty
• Dentist in Georgia

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