Active NPI
Moheet Mehboob Merchant, DDS
- General Practice Dentistry
- Los Angeles, CA
National Provider Identifier
1649731936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 105236
- Practice address
- 1517 W 6TH St
Los Angeles, CA 90017-1708 - Phone
- (213) 483-0772
- NPI assigned
- Mar 28, 2019
- Reactivated
- May 6, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 105236 | CA | Primary |
Addresses
Primary practice location
1517 W 6TH St
Los Angeles, CA 90017-1708
Mailing address
6537 Leland Way Apt 3
Los Angeles, CA 90028-7918
Phone (630) 396-0219
Other practice location 1
1307 S Euclid St
Anaheim, CA 92802-2001
Phone (714) 808-0228
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 |
|---|---|---|---|
| 105236 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chaulinh C. Mai, D.D.S, Inc | General Practice | Past | Accepting new patients |
| Yoon S. Kim DDS Inc. | General Practice | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba All Children's Dental
- General Practice Dentistry
- Anaheim, CA
- NPI 1598979775
-
dba Union Dental Center
- General Practice Dentistry
- Los Angeles, CA
- NPI 1497318885
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621814400000",
"number": "1649731936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6537 LELAND WAY APT 3",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900287918",
"telephone_number": "630-396-0219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1517 W 6TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900171708",
"telephone_number": "213-483-0772"
}
],
"practiceLocations": [
{
"address_1": "1307 S Euclid St",
"address_purpose": "LOCATION",
"city": "Anaheim",
"state": "CA",
"postal_code": "928022001",
"country_code": "US",
"telephone_number": "714-808-0228",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MERCHANT",
"first_name": "MOHEET",
"middle_name": "MEHBOOB",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-28",
"last_updated": "2021-05-24",
"certification_date": "2021-05-10",
"deactivation_date": "2021-03-16",
"reactivation_date": "2021-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "105236",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.