Individual provider Active NPI

Mozhgan Sadri

  • Dentist
  • Laurel, MD
National Provider Identifier
1134532948
Registry record updated May 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12148 Issued in MD
Practice address
12793 Laurel Bowie Rd
Laurel, MD 20708-2606
Phone
(301) 623-3737
NPI assigned
Jun 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12148 MD Primary

Addresses

Primary practice location

12793 Laurel Bowie Rd
Laurel, MD 20708-2606

Mailing address

12793 Laurel Bowie Rd
Laurel, MD 20708-2606
Phone (301) 623-3737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20150708001797 MD Order and Referring Only - DentistPractitioner - Dentist 1850603671

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12148MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ulery Dental and Orthodontics Dentist PastSince Feb 7, 2021 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": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432598400000",
    "number": "1134532948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12793 LAUREL BOWIE RD",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207082606",
            "telephone_number": "301-623-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12793 LAUREL BOWIE RD",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207082606",
            "telephone_number": "301-623-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADRI",
        "first_name": "MOZHGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2015-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "12148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.