Active NPI
Maral Emma Mobasher, DMD
- Pediatric Dentistry
- Alameda, CA
National Provider Identifier
1609261122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 101987
- Practice address
- 1105 Atlantic Ave Ste 101
Alameda, CA 94501-1185 - Phone
- (510) 521-5437
- NPI assigned
- Apr 1, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 101987 | CA | Primary |
Addresses
Primary practice location
1105 Atlantic Ave Ste 101
Alameda, CA 94501-1185
Mailing address
1105 Atlantic Ave Ste 101
Alameda, CA 94501-1185
Phone (510) 521-5437
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101987 | Other | CA | CALIFORNIA DENTAL LICENSE |
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 |
|---|---|---|---|
| 101987 | CA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640563200000",
"number": "1609261122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1105 ATLANTIC AVE STE 101",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945011185",
"telephone_number": "510-521-5437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 ATLANTIC AVE STE 101",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945011185",
"telephone_number": "510-521-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOBASHER",
"first_name": "MARAL",
"middle_name": "EMMA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-01",
"last_updated": "2021-12-27",
"certification_date": "2021-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "101987",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA DENTAL LICENSE",
"identifier": "101987",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Alameda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.