Individual provider Active NPI

Mohamed Elnahass, D.D.S.

  • Dentist
  • Fredericksburg, VA
National Provider Identifier
1194151449
Registry record updated Jun 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401415268 Issued in VA
Practice address
200 Executive Center Pkwy Ste 104
Fredericksburg, VA 22401
Phone
(540) 373-1641
Fax
(540) 373-7718
NPI assigned
Sep 18, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2018

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02545800 NJ
Dentist 122300000X 019029670 IL
Dentist 122300000X 04040 NH
Dentist 122300000X 0401415268 VA Primary
Dentist 122300000X DN20358 FL

Addresses

Primary practice location

200 Executive Center Pkwy Ste 104
Fredericksburg, VA 22401

Mailing address

200 Executive Center Pkwy Ste 104
Fredericksburg, VA 22401-3177
Phone (540) 373-1641

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN20358FLMDDentist
019029670ILMDDentist
22DI02545800NJMDDentist
0401415268VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jason T Lipscomb DDS P C Past 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": "1379462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1194151449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 EXECUTIVE CENTER PKWY STE 104",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013177",
            "telephone_number": "540-373-1641",
            "fax_number": "540-373-7718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EXECUTIVE CENTER PKWY STE 104",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "22401",
            "telephone_number": "540-373-1641",
            "fax_number": "540-373-7718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELNAHASS",
        "first_name": "MOHAMED",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-18",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02545800",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029670",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NH",
            "license": "04040",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401415268",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN20358",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.