Mounds View Family Dental

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

MOUNDS VIEW FAMILY DENTAL

Practice address

5366 Edgewood Dr.
Mounds View, MN 55112

Phone

(347) 481-6796

NPI assigned

Aug 24, 2009

Last updated

Aug 24, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sabry M Sharara, DDS

Title

Owner/President

Phone

(347) 481-6796

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251072000000",
    "number": "1205069358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2458 COUNTY ROAD I",
            "address_2": "APT. 201",
            "city": "MOUNDSVIEW",
            "state": "MN",
            "postal_code": "551126235",
            "telephone_number": "347-481-6796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5366 EDGEWOOD DR.",
            "city": "MOUNDS VIEW",
            "state": "MN",
            "postal_code": "55112",
            "telephone_number": "347-481-6796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNDS VIEW FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-24",
        "last_updated": "2009-08-24",
        "status": "A",
        "authorized_official_last_name": "SHARARA",
        "authorized_official_first_name": "SABRY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "347-481-6796",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Thomas Hanowski, DDS
• Kco Home Health Care LLC
• Chris Larson, D.C.
• Lifespan Health Services Inc
• Midwest Medical Services, Inc.
• Mounds View Operations, LLC (Bel Rae Senior Living)
• Outreach Transportation Services LLC (Outreach Transport)
• Phoenix Residence, Inc.
• Snyders Drug (Snyder Drug Emporium)
• Summerwoods Healthcare Services

• Dentist in Mounds View, MN
• Providers in Mounds View, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2009; 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.