Individual provider Active NPI

Tasneim A. Mohamed, DDS

  • General Practice Dentistry
  • Colorado Springs, CO
National Provider Identifier
1285909598
Registry record updated Jul 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
27785 Issued in TX
Practice address
3574 Hartsel Dr
Unit C
Colorado Springs, CO 80920-2108
Phone
(719) 266-9868
Fax
(719) 266-0889
NPI assigned
Mar 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10680 CO
General Practice Dentistry 1223G0001X 27785 TX Primary

Addresses

Primary practice location

3574 Hartsel Dr
Unit C
Colorado Springs, CO 80920-2108

Mailing address

4050 Regal Rose
San Antonio, TX 78259
Phone (210) 984-0361

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

LicenseStateTypeSpecialty
10680COMDGeneral Practice Dentistry
27785TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Western Dental Care General Practice PastSince Sep 1, 2019 Accepting new patients
Perfect Teeth - Woodman Valley P.C. General Practice Past Accepting new patients

Organizations & group practices 2

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": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499817600000",
    "number": "1285909598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 REGAL ROSE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78259",
            "telephone_number": "210-984-0361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3574 HARTSEL DR",
            "address_2": "UNIT C",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809202108",
            "telephone_number": "719-266-9868",
            "fax_number": "719-266-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMED",
        "first_name": "TASNEIM",
        "middle_name": "A.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-20",
        "last_updated": "2017-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "10680",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2017; 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.