Adil Shahbaz Moghul, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2022017694 Issued in MO

Practice address

319 NE Vivion Rd
Kansas City, MO 64118-4510

Phone

(816) 459-0000

NPI assigned

May 18, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1073250247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1437 GARDENA AVE NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554325815",
            "telephone_number": "612-558-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 NE VIVION RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641184510",
            "telephone_number": "816-459-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGHUL",
        "first_name": "ADIL",
        "middle_name": "SHAHBAZ",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-18",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2022017964",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2022017694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann C Modrcin, M.D.
• Kirsten Mody
• Mykayla Anne Moeschen, FNP
• Mary Elizabeth Moffatt, M.D.
• Behjat Moghadam
• Mohab LLC
• Islam Mohamed, MD
• Omar Ahmed Mohamed
• Irfan Aslam Mohammed, M.D.
• Marwa Mohammed, MD

• General Practice Dentistry in Kansas City, MO
• Providers in Kansas City, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.