Maxim Mossman, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

32197 Issued in TX

Practice address

3301 N K Ctr Apt C202
McAllen, TX 78501-1536

Phone

(972) 838-3772

NPI assigned

Oct 2, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1475366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1386193373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 N. K. CENTER ST.",
            "address_2": "APT. C-202",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "78501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 N K CTR APT C202",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785011536",
            "telephone_number": "972-838-3772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E 15th St",
            "address_2": "Ste 520",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761026550",
            "country_code": "US",
            "telephone_number": "214-732-0570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSSMAN",
        "first_name": "MAXIM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-02",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "32197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "316117601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in McAllen, TX
• Providers in McAllen, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.