Individual provider Active NPI

M Reza Moini, DDS

  • Dentist
  • Washington, DC
National Provider Identifier
1114086295
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN 4447 Issued in DC
Practice address
3301 New Mexico Ave NW
Suite 323
Washington, DC 20016
Phone
(202) 686-6333
Fax
(202) 636-6360
NPI assigned
Dec 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN 4447 DC Primary

Addresses

Primary practice location

3301 New Mexico Ave NW
Suite 323
Washington, DC 20016

Mailing address

3301 New Mexico Avenue NW
Suite 323
Washington, DC 20016
Phone (202) 686-6333

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

LicenseStateTypeSpecialty
DEN 4447DCMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114086295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 NEW MEXICO AVENUE NW",
            "address_2": "SUITE 323",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20016",
            "telephone_number": "202-686-6333",
            "fax_number": "202-636-6360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 NEW MEXICO AVE NW",
            "address_2": "SUITE 323",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20016",
            "telephone_number": "202-686-6333",
            "fax_number": "202-636-6360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOINI",
        "first_name": "M REZA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "DEN 4447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.