Mohammad Shiraz Haider, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

64017 Issued in CA

Practice address

20672 Lake Forest Dr
Lake Forest, CA 92630-7744

Phone

(949) 302-9124

NPI assigned

Jul 9, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Smile Works, a Dental Group of Farukhi P.C.

  • Dentist
  • La Mirada, CA
  • NPI 1588284475
  NPD (past) Authorized official

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431648000000",
    "number": "1134484900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3116 E WOODBINE RD",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928672090",
            "telephone_number": "949-302-9124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20672 LAKE FOREST DR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926307744",
            "telephone_number": "949-302-9124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIDER",
        "first_name": "MOHAMMAD",
        "middle_name": "SHIRAZ",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-09",
        "last_updated": "2015-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "64017",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.023830",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• H. Botshekan D.D.S (El Toro Dental Care)
• H. Jahangiri Dental Corporation
• Jennifer Haas
• Dina Haddad
• David C Haggard, DDS
• Marchelle Hall
• Sanalia Hall
• Paula Wilson Hambleton
• Micah Stephen Hamilton, DC
• Susan Hammoudeh

• Dentist in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2015; 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.