Active NPI
Mehrdad Moghaddari, DDS
- Public Health Dentistry
- Dahlonega, GA
National Provider Identifier
1588666309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health Dentistry
- License
- DN011636
- Practice address
- 56A Short St
Dahlonega, GA 30533-0543 - Phone
- (706) 867-2727
- Fax
- (706) 867-2739
- NPI assigned
- Aug 11, 2005
- 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 |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | DN011636 | GA | Primary |
Addresses
Primary practice location
56A Short St
Dahlonega, GA 30533-0543
Mailing address
2785 Gentry Walk CT
Cumming, GA 30041-7488
Phone (404) 457-3538
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 |
|---|---|---|---|
| DN011636 | GA | MD | Public Health Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1588666309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2785 GENTRY WALK CT",
"city": "CUMMING",
"state": "GA",
"postal_code": "300417488",
"telephone_number": "404-457-3538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56A SHORT ST",
"city": "DAHLONEGA",
"state": "GA",
"postal_code": "305330543",
"telephone_number": "706-867-2727",
"fax_number": "706-867-2739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOGHADDARI",
"first_name": "MEHRDAD",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-11",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "GA",
"license": "DN011636",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dahlonega, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.