Active NPI
Youstina Mozeih Shaker Mikhail, BDS
- Periodontics
- Flower Mound, TX
National Provider Identifier
1225648017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 40041
- Practice address
- 651 Cross Timbers Rd Ste 102
Flower Mound, TX 75028-1300 - Phone
- (951) 603-4336
- NPI assigned
- Aug 5, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | RES.004283 | OH | |
| Periodontics | 1223P0300X | 40041 | TX | Primary |
Addresses
Primary practice location
651 Cross Timbers Rd Ste 102
Flower Mound, TX 75028-1300
Mailing address
4000 S Broadway Ave Apt 137
Flower Mound, TX 75028-7670
Phone (951) 603-4336
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 |
|---|---|---|---|
| RES.004283 | OH | MD | General Practice Dentistry |
| 40041 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695600000000",
"number": "1225648017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4000 S BROADWAY AVE APT 137",
"city": "FLOWER MOUND",
"state": "TX",
"postal_code": "750287670",
"telephone_number": "951-603-4336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "651 CROSS TIMBERS RD STE 102",
"city": "FLOWER MOUND",
"state": "TX",
"postal_code": "750281300",
"telephone_number": "951-603-4336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIKHAIL",
"first_name": "YOUSTINA",
"middle_name": "MOZEIH SHAKER",
"credential": "BDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-05",
"last_updated": "2023-09-25",
"certification_date": "2023-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "RES.004283",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "TX",
"license": "40041",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flower Mound, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.