Individual provider Active NPI

A M Sohal Mahamud

  • General Practice Dentistry
  • Madera, CA
National Provider Identifier
1396514519
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
109775 Issued in CA
Practice address
1100 N Gateway Dr
Madera, CA 93637-9600
Phone
(559) 363-4160
NPI assigned
Dec 28, 2023
Last updated
Jul 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 109775 CA Primary

Addresses

Primary practice location

1100 N Gateway Dr
Madera, CA 93637-9600

Mailing address

3661 Utah LN
Clovis, CA 93619-2007
Phone (929) 350-7495

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

LicenseStateTypeSpecialty
109775CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Am Sohal Mahamud DDS Inc General Practice Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1703721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1396514519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3661 UTAH LN",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936192007",
            "telephone_number": "929-350-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N GATEWAY DR",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936379600",
            "telephone_number": "559-363-4160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAMUD",
        "first_name": "A M SOHAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-28",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "109775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2025; 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.