Active NPI
Mohammad Ali Tabatabaeei-Fatemi, D.D.S.
- General Practice Dentistry
- Lexington Park, MD
National Provider Identifier
1154373413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11720
- Practice address
- 22684 Three Notch Rd
Lexington Park, MD 20653-2154 - Phone
- (301) 737-4747
- NPI assigned
- May 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11720 | MD | Primary |
Addresses
Primary practice location
22684 Three Notch Rd
Lexington Park, MD 20653-2154
Mailing address
12401 Bacall LN
Potomac, MD 20854-1026
Phone (301) 812-0299
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11720 | MD | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464307200000",
"number": "1154373413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12401 BACALL LN",
"city": "POTOMAC",
"state": "MD",
"postal_code": "208541026",
"telephone_number": "301-812-0299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22684 THREE NOTCH RD",
"city": "LEXINGTON PARK",
"state": "MD",
"postal_code": "206532154",
"telephone_number": "301-737-4747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABATABAEEI-FATEMI",
"first_name": "MOHAMMAD",
"middle_name": "ALI",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2016-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "11720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.