Individual provider Active NPI

Mohammed A Zobaer, D.D.S

  • General Practice Dentistry
  • Costa Mesa, CA
National Provider Identifier
1609930700
Registry record updated May 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
100078 Issued in CA
Practice address
2000 Harbor Blvd Ste B100
Costa Mesa, CA 92627-2601
Phone
(949) 645-5070
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 100078 CA Primary
General Practice Dentistry 1223G0001X D12190 MN

Addresses

Primary practice location

2000 Harbor Blvd Ste B100
Costa Mesa, CA 92627-2601

Mailing address

4 Shale
Coto de Caza, CA 92679-5233
Phone (763) 670-3165

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

LicenseStateTypeSpecialty
D12190MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Cox Dental Coprporation General Practice PastSince Jan 17, 2022 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1609930700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SHALE",
            "city": "COTO DE CAZA",
            "state": "CA",
            "postal_code": "926795233",
            "telephone_number": "763-670-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 HARBOR BLVD STE B100",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926272601",
            "telephone_number": "949-645-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOBAER",
        "first_name": "MOHAMMED",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "100078",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12190",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.

Verify at the official NPI Registry.