Individual provider Active NPI

Sara Mohasel Mofrad, D.D.S

  • Dentist
  • Long Beach, CA
National Provider Identifier
1225811722
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS109074 Issued in CA
Practice address
7370 Carson Blvd
Long Beach, CA 90808-2360
Phone
(562) 247-9789
NPI assigned
Aug 17, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS109074 CA Primary

Addresses

Primary practice location

7370 Carson Blvd
Long Beach, CA 90808-2360

Mailing address

7370 Carson Blvd
Long Beach, CA 90808-2360
Phone (056) 224-7978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240904000490 CA Order and Referring Only - DentistPractitioner - Dentist 0143760231

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS109074CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Wu and Najafi Dental Corporation Dentist CurrentSince Aug 27, 2023 Accepting new patients

Locations

7370 Carson Blvd
Long Beach, CA 90808
Phone (562) 247-9789

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": "1692230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1225811722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7370 CARSON BLVD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908082360",
            "telephone_number": "056-224-7978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7370 CARSON BLVD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908082360",
            "telephone_number": "562-247-9789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFRAD",
        "first_name": "SARA",
        "middle_name": "MOHASEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-17",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS109074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.