Individual provider Active NPI

Moniza Munawar

  • Dentist
  • Garland, TX
National Provider Identifier
1124495189
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
31352 Issued in TX
Practice address
4441 Bass Pro Dr
Garland, TX 75043-4837
Phone
(972) 349-6320
NPI assigned
Aug 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 31352 TX
Dentist 122300000X 31352 TX Primary

Addresses

Primary practice location

4441 Bass Pro Dr
Garland, TX 75043-4837

Mailing address

1010 Carson Dr
Allen, TX 75002-1715
Phone (214) 948-3364

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200327001593 TX Practitioner - DentistPractitioner - Oral Surgery 1658700547

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31352TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Cliff Dental Center General Practice PastSince Feb 13, 2020 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.

NPI Registry JSON

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1124495189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 CARSON DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750021715",
            "telephone_number": "214-948-3364",
            "fax_number": "214-948-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4441 BASS PRO DR",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750434837",
            "telephone_number": "972-349-6320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNAWAR",
        "first_name": "MONIZA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-26",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "31352",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "31352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.