Maryam Moakhar Habibi, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 18686 Issued in FL

Practice address

1764 Bruce B Downs Blvd
Wesley Chapel, FL 33544-8640

Phone

(813) 528-4006

NPI assigned

Jul 26, 2009

Sex

Female

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

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1248566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485043200000",
    "number": "1356571251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1764 BRUCE B DOWNS BLVD",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335448640",
            "telephone_number": "813-528-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1764 BRUCE B DOWNS BLVD",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335448640",
            "telephone_number": "813-528-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABIBI",
        "first_name": "MARYAM",
        "middle_name": "MOAKHAR",
        "name_prefix": "Mrs.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-26",
        "last_updated": "2017-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 18686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eva Gupta, MD
• Sumit Gupta, M.D.
• Safa Mustafa Gurwala
• Crystal Lynn Gwinn, BCBA
• Cassidy Rae Haberland
• Amber Hackett, LCSW
• Kelsey McKay Hackler, LCSW
• Ayele Hadero, MD
• Susan Lynn Hale
• Abigail Elizabeth Hall

• General Practice Dentistry in Wesley Chapel, FL
• Providers in Wesley Chapel, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.