Active NPI
Sara Selina Mouzi-Escobedo, D.D.S.
- Dentist
- Atlanta, GA
National Provider Identifier
1336451467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN122410
- Practice address
- 955 Memorial Dr SE Ste 534
Atlanta, GA 30316-1566 - Phone
- (048) 364-5954
- NPI assigned
- Jul 6, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 25563 | TX | |
| Dentist | 122300000X | DN122410 | GA | Primary |
Addresses
Primary practice location
955 Memorial Dr SE Ste 534
Atlanta, GA 30316-1566
Mailing address
4241 Dickson St
Houston, TX 77007-7352
Phone (832) 715-1595
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN122410 | GA | MD | Dentist |
| 25563 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brident Dental Associates PC | Dentist | Past | Accepting new patients |
| South Texas Dental Associates, L.P. | 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.
-
- Dentist
- Houston, TX
- NPI 1861965956
-
- General Practice Dentistry
- Houston, TX
- NPI 1942490289
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692748800000",
"number": "1336451467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4241 DICKSON ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770077352",
"telephone_number": "832-715-1595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "955 MEMORIAL DR SE STE 534",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303161566",
"telephone_number": "048-364-5954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUZI-ESCOBEDO",
"first_name": "SARA",
"middle_name": "SELINA",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-06",
"last_updated": "2023-08-23",
"certification_date": "2023-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "25563",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "DN122410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.