Active NPI
Mohamed A Gouda, D.D.S.
- Dentist
- Porterville, CA
National Provider Identifier
1073662458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 48456
- Practice address
- 827 W Henderson Ave
Porterville, CA 93257-1742 - Phone
- (559) 782-9297
- Fax
- (559) 782-9255
- NPI assigned
- Jan 9, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 48456 | CA | Primary |
Addresses
Primary practice location
827 W Henderson Ave
Porterville, CA 93257-1742
Mailing address
827 W Henderson Ave
Porterville, CA 93257-1742
Phone (559) 782-9297
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48456 | CA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gouda Dental Corporation | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Porterville, CA
- NPI 1700068475
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196812800000",
"number": "1073662458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "827 W HENDERSON AVE",
"city": "PORTERVILLE",
"state": "CA",
"postal_code": "932571742",
"telephone_number": "559-782-9297",
"fax_number": "559-782-9255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "827 W HENDERSON AVE",
"city": "PORTERVILLE",
"state": "CA",
"postal_code": "932571742",
"telephone_number": "559-782-9297",
"fax_number": "559-782-9255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOUDA",
"first_name": "MOHAMED",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-09",
"last_updated": "2007-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "48456",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Porterville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.