Mozhgan Riahi Mashhadi

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

109837 Issued in CA

Practice address

25175 Corcubion
Mission Viejo, CA 92692

Phone

(949) 490-8777

NPI assigned

Feb 2, 2024

Last updated

Mar 8, 2024By the provider in NPPES

Sex

Female

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 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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1225891104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25175 CORCUBION",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92692",
            "telephone_number": "949-490-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25175 CORCUBION",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92692",
            "telephone_number": "949-490-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIAHI MASHHADI",
        "first_name": "MOZHGAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "109837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Revive Recovery Center LLC
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• Jeffrey Alan Rey, M.D.
• Isaya Michael Reyes, DPT
• Layla S Rezaeepour, RN/NP
• Richard J. Claveria, MD a Professional Medical Corporation
• Richard Jin MD, Inc.
• Richard K. Hada, DMD, PC
• Richards Physical Therapy Inc (Professional Physical Therapy)
• Richards Physical Therapy Inc (DBA Professional Physical Therapy)

• General Practice Dentistry in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; 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.