Mary Gharagozloo, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN20942 Issued in FL

Practice address

338-A North Magnolia Ave
Orlando, FL 32801

Phone

(407) 648-3688

Fax

(407) 648-8306

NPI assigned

Jul 18, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

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.

• Legacy Smiles of Orlando

  • General Practice Dentistry
  • Orlando, FL
  • NPI 1679333447
  NPD (past)

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442361600000",
    "number": "1144429259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338-A NORTH MAGNOLIA AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32801",
            "telephone_number": "407-648-3688",
            "fax_number": "407-648-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338-A NORTH MAGNOLIA AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32801",
            "telephone_number": "407-648-3688",
            "fax_number": "407-648-8306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHARAGOZLOO",
        "first_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-18",
        "last_updated": "2015-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN20942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashkan Ghaneie, MD
• Muhammad Ghanem, MD
• Mohammad Usman Ghani
• Sarah Ghany-Yar
• Farid Gharagozloo, M.D.
• Athar Ghassemi Bolourchi
• Shamini Ghay, ARNP
• Darshan K Ghayal, PT
• Krina Ghayal, FNP
• Andrei Cristian Gheorghe

• Dentist in Orlando, FL
• Providers in Orlando, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.