Mohammed Mansour, BDS, MS

Primary specialty

DentistTaxonomy code 122300000X

License

24193 Issued in TX

Practice address

3305 Mosswood Dr
Plano, TX 75074-8940

Phone

(469) 230-7338

NPI assigned

Aug 28, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364428800000",
    "number": "1093963357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 MOSSWOOD DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75074",
            "telephone_number": "469-230-7338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 MOSSWOOD DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750748940",
            "telephone_number": "469-230-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "MOHAMMED",
        "name_prefix": "Dr.",
        "credential": "BDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-28",
        "last_updated": "2013-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "24193",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "24193",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "TX",
            "license": "24193",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mansfield Prestige Anesthesia PLLC
• Tina Manshadi, M.D.
• Breanna A Manson
• Hoss Mansoori, FNP-C
• Jasmin Mansoori, DPM
• Pavanya Mantena
• Matthias Marvin Manuel, MD, MPH
• Svetlana Nikolaeva Manukyan, NP
• Saad Mahmoud-Adam Manzoul, MD
• Pechrodeth Mao

• Dentist in Plano, TX
• Providers in Plano, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; 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.

Verify at the official NPI Registry.