Active NPI
Farnosh Mojtabaee, DDS
- General Practice Dentistry
- Austin, TX
National Provider Identifier
1528611019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 35410
- Practice address
- 1450 W Parmer LN
Austin, TX 78727-4501 - Phone
- (512) 251-6125
- NPI assigned
- Jul 23, 2019
- Last updated
- Jul 23, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 35410 | TX | Primary |
Addresses
Primary practice location
1450 W Parmer LN
Austin, TX 78727-4501
Mailing address
3024 Shane Dr
Leander, TX 78641-4500
Phone (512) 905-6582
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35410 | Other | TX | TEXAS STATE BOARD OF DENTAL EXAMINERS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35410 | TX | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vince Tri Hoang DDS | General Practice | Past | Accepting new patients |
Interoperability endpoints
- farnosh.mojtabaee.p1@direct.lscctx.nextgenshare.com
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563840000000",
"number": "1528611019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3024 SHANE DR",
"city": "LEANDER",
"state": "TX",
"postal_code": "786414500",
"telephone_number": "512-905-6582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 W PARMER LN",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787274501",
"telephone_number": "512-251-6125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOJTABAEE",
"first_name": "FARNOSH",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-23",
"last_updated": "2019-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "35410",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS STATE BOARD OF DENTAL EXAMINERS",
"identifier": "35410",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.