Sasan Molavi, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

1001793 Issued in WI

Practice address

6100 Washington Ave Ste F2
Mount Pleasant, WI 53406-4000

Phone

(262) 999-9998

NPI assigned

Jun 28, 2009

Last updated

Jun 16, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mynt Dental Racine LLC

  • General Practice Dentistry
  • Mount Pleasant, WI
  • NPI 1235628454
  NPD Authorized official
• Mynt Dental Bolingbrook LLC

  • Dentist
  • Bolingbrook, IL
  • NPI 1255906244
  NPD Authorized official
• Mynt Dental Frannklin Park LLC

  dba Mynt Dental

  • General Practice Dentistry
  • Franklin Park, IL
  • NPI 1588042642
  NPD Authorized official
• Alpina Dental MP LLC

  • General Practice Dentistry
  • Mount Pleasant, WI
  • NPI 1124723721
  Authorized official Same address or phone

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

{
    "created_epoch": "1246147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1467680504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 WASHINGTON AVE STE F2",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534064000",
            "telephone_number": "630-381-8281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 WASHINGTON AVE STE F2",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534064000",
            "telephone_number": "262-999-9998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2731 Mannheim Rd",
            "address_purpose": "LOCATION",
            "city": "Franklin Park",
            "state": "IL",
            "postal_code": "601312219",
            "country_code": "US",
            "telephone_number": "312-999-9995",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6100 Washington Ave Ste F2",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "WI",
            "postal_code": "53406",
            "country_code": "US",
            "telephone_number": "262-999-9998",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "231 N Bolingbrook Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Bolingbrook",
            "state": "IL",
            "postal_code": "604401960",
            "country_code": "US",
            "telephone_number": "312-999-9993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLAVI",
        "first_name": "SASAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-28",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "25283",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027961",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD3585",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100076929",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara B Mizer, MSW,LCSW,CSAC
• Jinkle Privesh Modi
• Christina L Moffett, MA, CCC-SLP
• Mohd Noman Mohiuddin, M.D
• Emily Mohr
• Moments Hospice of Milwaukee (Moments Hospice)
• Maksim Montatskiy, DMD
• Susan E Moore Schneider, MSW, LCSW
• Angela Christina Morales-Talavera, FNP
• Kryssi Morales, CF-SLP

• Dentist in Mount Pleasant, WI
• Providers in Mount Pleasant, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.