Individual provider Active NPI

Berween Mourady, DDS

  • Dentist
  • Highlands Ranch, CO
National Provider Identifier
1114098308
Registry record updated Apr 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10279 Issued in CO
Practice address
1165 SGT. Jon Stiles Drive
Highlands Ranch, CO 80129
Phone
(651) 431-8148
NPI assigned
Nov 11, 2006
Last updated
Apr 8, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10279 CO Primary

Addresses

Primary practice location

1165 SGT. Jon Stiles Drive
Highlands Ranch, CO 80129

Mailing address

1165 SGT Jon Stiles Dr
Highlands Ranch, CO 80129-2246
Phone (651) 431-8148

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
10279COMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1163203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302220800000",
    "number": "1114098308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 SGT JON STILES DR",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801292246",
            "telephone_number": "651-431-8148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 SGT. JON STILES DRIVE",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "80129",
            "telephone_number": "651-431-8148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOURADY",
        "first_name": "BERWEEN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-11",
        "last_updated": "2011-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "10279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highlands Ranch, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2011; 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.