Organization Active NPI

Moonlight Dental Center

  • Dentist
  • Houston, TX
National Provider Identifier
1376987354
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
20175 Issued in TX
Legal business name
MOONLIGHT DENTAL CENTER
Practice address
7703 Beechnut St
Houston, TX 77074-3101
Phone
(713) 974-7252
Fax
(713) 974-5822
NPI assigned
Apr 22, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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

Authorized official

Name
Dr. Mahin Rahgozar, DDS
Title
DDS/Owner
Phone
(713) 974-7252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 20175 TX Primary

Addresses

Primary practice location

7703 Beechnut St
Houston, TX 77074-3101

Mailing address

2500 Fondren Rd
Suite 205
Houston, TX 77063-2308
Phone (713) 974-7252

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366675200000",
    "number": "1376987354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 FONDREN RD",
            "address_2": "SUITE 205",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770632308",
            "telephone_number": "713-974-7252",
            "fax_number": "713-974-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7703 BEECHNUT ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770743101",
            "telephone_number": "713-974-7252",
            "fax_number": "713-974-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOONLIGHT DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-22",
        "last_updated": "2013-04-23",
        "status": "A",
        "authorized_official_last_name": "RAHGOZAR",
        "authorized_official_first_name": "MAHIN",
        "authorized_official_title_or_position": "DDS/OWNER",
        "authorized_official_telephone_number": "713-974-7252",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "20175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; 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.