Mohammed Abdul Mujeeb, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 13401 Issued in FL

Practice address

3226 Lake Washington Rd
Suite 16
Melbourne, FL 32934-7620

Phone

(321) 255-1991

Fax

(321) 752-0011

NPI assigned

Aug 9, 2006

Sex

Male

Sole proprietor

No

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.

• Professional Dental Alliance of Lake Washington, PLLC

  • General Practice Dentistry
  • Melbourne, FL
  • NPI 1558840371
  NPD (past)

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194735571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3520 CHARLTON PL",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329348344",
            "telephone_number": "321-255-1991",
            "fax_number": "321-752-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3226 LAKE WASHINGTON RD",
            "address_2": "SUITE 16",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329347620",
            "telephone_number": "321-255-1991",
            "fax_number": "321-752-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUJEEB",
        "first_name": "MOHAMMED",
        "middle_name": "ABDUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 13401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Mucelli
• Kenneth Edwin Muck, LMT
• Jennifer Mugg
• Lillian Muhammad
• Mujeeb DDS,PA
• Milan M Mukerji, MD
• Andrew James Mullen
• Kelley Marie Mullican, FNP-BC
• Azeb Muluneh, PHARMD
• Gwen Mundorf, MSW, LCSW

• General Practice Dentistry in Melbourne, FL
• Providers in Melbourne, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.