Mohamed Samy Moustafa, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD5353 Issued in NM

Practice address

1710 W Joe Harvey Blvd Ste B
Hobbs, NM 88240-0821

Phone

(575) 738-0335

NPI assigned

Jun 19, 2020

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)

Not enrolled

State licenses

Practice roles

Locations

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.

• Familia Dental Hob LLC

  • Dental Clinic/Center
  • Hobbs, NM
  • NPI 1932474004

  General Practice

  NPD

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1154947646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 E ALGONQUIN RD STE 610",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734166",
            "telephone_number": "888-988-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 W JOE HARVEY BLVD STE B",
            "city": "HOBBS",
            "state": "NM",
            "postal_code": "882400821",
            "telephone_number": "575-738-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSTAFA",
        "first_name": "MOHAMED",
        "middle_name": "SAMY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-19",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN24964",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD5353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tony Morales
• Marisol Moriel, OT
• Brock Wade Morris, CFNP
• Ambrea Mosley
• Mitzi Joy Mossman, RN
• Kirtiben Mulji
• Larry E Munoz
• Mark Munro, LPCC
• Julia N Murillo
• Katie Murillo, BT

• General Practice Dentistry in Hobbs, NM
• Providers in Hobbs, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.