Individual provider Active NPI

Hani Mohsenzadeh, DDS, RDH

  • Dentist
  • Santa Rosa, CA
National Provider Identifier
1497064992
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
107197 Issued in CA
Practice address
144 Stony Point Rd
Santa Rosa, CA 95401-4122
Phone
(707) 521-4500
NPI assigned
Sep 30, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 24498 CA
Dentist 122300000X 107197 CA Primary

Addresses

Primary practice location

144 Stony Point Rd
Santa Rosa, CA 95401-4122

Mailing address

41 Royal Gorge St
Santa Rosa, CA 95409-4281
Phone (619) 274-5796

Other identifiers 1

IdentifierTypeStateIssuer
1497064992MedicaidCA

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
107197CAMDDentist
24498CAMDPhysical Therapist

Interoperability endpoints

  • Direct secure messaging: hmohsenzadeh764180@direct.ochin.org
  • Direct secure messaging: hani.mohsenzadeh.d1.p1@direct.scihp.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1285804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1497064992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 ROYAL GORGE ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954094281",
            "telephone_number": "619-274-5796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 STONY POINT RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014122",
            "telephone_number": "707-521-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHSENZADEH",
        "first_name": "HANI",
        "name_prefix": "Dr.",
        "credential": "DDS, RDH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-30",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "24498",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "107197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497064992",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.