Active NPI
Sam Mouchamel, DDS
- Dentist
- Burbank, CA
National Provider Identifier
1508081449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 40861
- Practice address
- 1319 N San Fernando Blvd
Burbank, CA 91504 - Phone
- (818) 557-2299
- Fax
- (818) 557-8749
- NPI assigned
- Apr 16, 2007
- 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 | 40861 | CA | Primary |
Addresses
Primary practice location
1319 N San Fernando Blvd
Burbank, CA 91504
Mailing address
1319 N San Fernando Blvd
Burbank, CA 91504
Phone (818) 557-2299
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G9109701 | Other | CA | MEDICAL |
Other names 1
- Sulaiman Mouchamel
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
| License | State | Type | Specialty |
|---|---|---|---|
| 40861 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hattar Dental Professional Corporation | Dentist | Past | Accepting new patients |
| Mouchamel Dental Corporation | Dentist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Burbank, CA
- NPI 1568645216
-
- Dentist
- Burbank, CA
- NPI 1851416333
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508081449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1319 N SAN FERNANDO BLVD",
"city": "BURBANK",
"state": "CA",
"postal_code": "91504",
"telephone_number": "818-557-2299",
"fax_number": "818-557-8749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1319 N SAN FERNANDO BLVD",
"city": "BURBANK",
"state": "CA",
"postal_code": "91504",
"telephone_number": "818-557-2299",
"fax_number": "818-557-8749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUCHAMEL",
"first_name": "SAM",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "40861",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "G9109701",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SULAIMAN",
"last_name": "MOUCHAMEL",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Burbank, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.