Alexander Mazratian, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

17151 Issued in TX

Practice address

1110 Longfellow Dr
Suite B
Beaumont, TX 77706-4820

Phone

(409) 898-2068

NPI assigned

Aug 14, 2006

Last updated

Jul 21, 2022By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1578576435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 LONGFELLOW DR",
            "address_2": "SUITE B",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777064820",
            "telephone_number": "409-898-2068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 LONGFELLOW DR",
            "address_2": "SUITE B",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777064820",
            "telephone_number": "409-898-2068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZRATIAN",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "17151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007762001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caitlin Leann May, SLP
• Joni May, M.S., CCC-SLP
• Tangee Mayes
• James Edward Mayeux, CRNA
• Malonie Mayfield, LVN
• Chinwe Maureen Mbonu, NP
• Felicia McAdams
• Dana N. McAlexander, ATP
• Kara McAnulty
• Mathew Garth McBee, D.D.S.

• Periodontics in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.