Reyhaneh Alimohammadi
Individual provider Active NPI Oral and Maxillofacial Radiology Dentistry · Tomball, TX
NPI 1306337449 · NPPES record last updated Jun 16, 2018
Key facts
- NPI
- 1306337449
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Oral and Maxillofacial Radiology Dentistry 1223X0008X
- License
- 33922 (TX)
- Practice address
- 28602 Tomball Pkwy Ste B
Tomball, TX 77375-4204 - Phone
- (281) 256-7554
- NPI assigned
- May 24, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180814001050 | TX | Order and Referring Only - Dentist |
7517216237 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33922 | TX | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tomball Smiles Dentistry, PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Radiology Dentistry | 1223X0008X | 33922 | TX | Yes |
Addresses
Primary practice location
28602 Tomball Pkwy Ste B
Tomball, TX 77375-4204
Mailing address
1 Waterway Ave Apt 1257
Spring, TX 77380-3455
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | NA |
Other providers in Tomball, TX
- Shaikh Ali
- Align and Equip Consulting LLC
- Align Therapeutics PLLC
- Aligned Family Chiropractic
- Aligned Therapeutic Providers PLLC
- Dhuha Majeed Alkhaiat
- All Care Therapy Staffing Solutions, LLC
- Miranda L Allen
- Allied Pain Partners LLC
- Allison Hulett LCSW PLLC
All providers in Tomball, TX · Oral and Maxillofacial Radiology Dentistry in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.