Individual provider Active NPI

Mohamed Gara

  • Dentist
  • Bakersfield, CA
National Provider Identifier
1356033088
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
109005 Issued in CA
Practice address
3318 Niles St
Bakersfield, CA 93306-4424
Phone
(661) 495-5535
NPI assigned
May 22, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 109005 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3318 Niles St
Bakersfield, CA 93306-4424

Mailing address

3318 Niles St
Bakersfield, CA 93306-4424

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240606003832 CA Practitioner - Dentist 0143762062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
109005CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Family Health Current Accepting new patients
Azad DMD Inc CurrentSince May 28, 2023 Accepting new patients

Locations

4900 California Ave
Ste 400B
Bakersfield, CA 93309
Phone (661) 630-7046

3318 Niles St
Bakersfield, CA 93306
Phone (661) 214-8641

277 E Front St
Buttonwillow, CA 93206
Phone (661) 630-7381

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": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1356033088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3318 NILES ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933064424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3318 NILES ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933064424",
            "telephone_number": "661-495-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARA",
        "first_name": "MOHAMED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "109005",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.