Individual provider Active NPI

Ghazal Mofrad, DDS

  • Dentist
  • Las Vegas, NV
National Provider Identifier
1225762735
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7675 Issued in NV
Practice address
8975 W Charleston Blvd Ste 100
Las Vegas, NV 89117-5473
Phone
(702) 290-4212
Fax
(702) 228-2907
NPI assigned
Jul 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7675 NV Primary

Addresses

Primary practice location

8975 W Charleston Blvd Ste 100
Las Vegas, NV 89117-5473

Mailing address

8975 W Charleston Blvd Ste 100
Las Vegas, NV 89117-5473
Phone (702) 290-4212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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

Enrollment IDStateProvider typePAC IDDetails
I20231023001127 NV Order and Referring Only - DentistPractitioner - Dentist 5890141162

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
King Rampart Dental Group, PC PastSince Aug 17, 2025 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": "1657497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1225762735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8975 W CHARLESTON BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891175473",
            "telephone_number": "702-290-4212",
            "fax_number": "702-228-2907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8975 W CHARLESTON BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891175473",
            "telephone_number": "702-290-4212",
            "fax_number": "702-228-2907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFRAD",
        "first_name": "GHAZAL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-11",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "7675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.