Active NPI
Indra Z Mustapha, DDA, MS, PHD
- Dentist
- Washington, DC
National Provider Identifier
1639315377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DEN5830
- Practice address
- 1221 Massachusetts Ave NW
Washington, DC 20005-5302 - Phone
- (202) 628-7979
- NPI assigned
- Dec 31, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 12138 | MD | |
| Dentist | 122300000X | DEN5830 | DC | Primary |
Addresses
Primary practice location
1221 Massachusetts Ave NW
Washington, DC 20005-5302
Mailing address
1221 Massachusetts Ave NW
Washington, DC 20005-5302
Phone (202) 628-7979
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
- Credentials
- Master of Science, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN5830 | DC | MD | Dentist |
| 12138 | MD | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436313600000",
"number": "1639315377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1221 MASSACHUSETTS AVE NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200055302",
"telephone_number": "202-628-7979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 MASSACHUSETTS AVE NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200055302",
"telephone_number": "202-628-7979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUSTAPHA",
"first_name": "INDRA",
"middle_name": "Z",
"credential": "DDA, MS, PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-31",
"last_updated": "2015-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MD",
"license": "12138",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "DC",
"license": "DEN5830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.