Sasan Moghaddame-Jafari

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

13190 Issued in MD

Practice address

11921 Rockville Pike Ste 405
Rockville, MD 20852-2757

Phone

(301) 984-3636

Fax

(301) 984-3635

NPI assigned

Jan 19, 2007

Last updated

Nov 15, 2021By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sasan Moghaddame-Jafari Ms DDS PA

  • Endodontics
  • Rockville, MD
  • NPI 1306009550
  NPD (past) Authorized official

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1245383710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 THOMAS JOHNSON DR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11921 ROCKVILLE PIKE STE 405",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522757",
            "telephone_number": "301-984-3636",
            "fax_number": "301-984-3635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGHADDAME-JAFARI",
        "first_name": "SASAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MD",
            "license": "13190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endodontics in Rockville, MD
• Providers in Rockville, MD by specialty
• Endodontics in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.