Individual provider Active NPI

Rakan Adnan Muqatash

  • Dentist
  • Mesa, AZ
National Provider Identifier
1134051378
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D012832 Issued in AZ
Practice address
107 N Greenfield Rd Ste 2
Mesa, AZ 85205-7802
Phone
(480) 832-5190
NPI assigned
Jun 2, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D012832 AZ Primary

Addresses

Primary practice location

107 N Greenfield Rd Ste 2
Mesa, AZ 85205-7802

Mailing address

2084 Donovan Dr
Lincoln, CA 95648-2966
Phone (916) 884-3538

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
D012832AZMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1780358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1134051378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2084 DONOVAN DR",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956482966",
            "telephone_number": "916-884-3538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N GREENFIELD RD STE 2",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852057802",
            "telephone_number": "480-832-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUQATASH",
        "first_name": "RAKAN",
        "middle_name": "ADNAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-06-02",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D012832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; 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.