Active NPI
Nasr Mousa Botrous Mousa, DDS
- Dentist
- Shafter, CA
National Provider Identifier
1497807168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 52089
- Practice address
- 659 S Central Valley Hwy
Shafter, CA 93263-2790 - Phone
- (661) 459-1900
- Fax
- (661) 459-1974
- NPI assigned
- Jan 16, 2007
- Last updated
- Apr 26, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 52089 | CA | Primary |
Addresses
Primary practice location
659 S Central Valley Hwy
Shafter, CA 93263-2790
Mailing address
2309 Cullen CT Apt a
Bakersfield, CA 93314-6578
Phone (760) 554-5065
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335398400000",
"number": "1497807168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2309 CULLEN CT APT A",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933146578",
"telephone_number": "760-554-5065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "659 S CENTRAL VALLEY HWY",
"city": "SHAFTER",
"state": "CA",
"postal_code": "932632790",
"telephone_number": "661-459-1900",
"fax_number": "661-459-1974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUSA",
"first_name": "NASR",
"middle_name": "MOUSA BOTROUS",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-16",
"last_updated": "2012-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "52089",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shafter, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.