Nastaran Moshaeinezhad, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DGD.10596 Issued in SC

Practice address

1209 N Retail CT
Myrtle Beach, SC 29577-9626

Phone

(843) 357-0213

NPI assigned

Mar 31, 2023

Last updated

Jul 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Rose Moshaeinezhad Professional name

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": "1680220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1407551401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 BLUFFVIEW DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295795268",
            "telephone_number": "718-808-3942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 N RETAIL CT",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295779626",
            "telephone_number": "843-357-0213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSHAEINEZHAD",
        "first_name": "NASTARAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-31",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "DGD.10596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSE",
            "last_name": "MOSHAEINEZHAD",
            "prefix": "DR.",
            "credential": "DDS, MPH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kristopher Morris, HAS
• Lyndzy Marie Morris
• Grant Morrison, MD
• Maria Morrison, M.A., CF - SLP
• Nicole Mortel
• Victoria Elizabeth Moshoures, MD
• Christina Elizabeth Moskal, AA
• Danielle Dorothy Mounts
• Christopher Stavros Moutopoulos, DPT
• Movement Counseling

• General Practice Dentistry in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.