NPIMap

Organization Active NPI

Haitham Mosly, DMD, a Professional Corporation

  • Dentist
  • Roseville, CA
National Provider Identifier
1427435809
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
61008 Issued in CA
Legal business name
HAITHAM MOSLY, DMD, A PROFESSIONAL CORPORATION
Practice address
1740 Santa Clara Dr
Suite 100-B
Roseville, CA 95661-2921
Phone
(916) 797-0406
NPI assigned
May 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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

Authorized official

Name
Haitham MoslyNPI 1952407504
Title
DMD/Practice Owner
Phone
(916) 797-0406

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 61008 CA Primary

Addresses

Primary practice location

1740 Santa Clara Dr
Suite 100-B
Roseville, CA 95661-2921

Mailing address

1740 Santa Clara Dr
Suite 100-B
Roseville, CA 95661-2921

National Provider Directory

National Provider Directory

Locations

1740 Santa Clara Dr
Ste 100B
Roseville, CA 95661
Phone (916) 797-0406

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430784000000",
    "number": "1427435809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 SANTA CLARA DR",
            "address_2": "SUITE 100-B",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 SANTA CLARA DR",
            "address_2": "SUITE 100-B",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612921",
            "telephone_number": "916-797-0406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAITHAM MOSLY, DMD, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-05",
        "last_updated": "2015-05-05",
        "status": "A",
        "authorized_official_last_name": "MOSLY",
        "authorized_official_first_name": "HAITHAM",
        "authorized_official_title_or_position": "DMD/PRACTICE OWNER",
        "authorized_official_telephone_number": "916-797-0406"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "61008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; 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.