David Jason Mohorn, DDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

6366 Issued in NC

Practice address

408 Parkway
Suite A1
Greensboro, NC 27401-1661

Phone

(336) 663-8586

Fax

(877) 710-7903

NPI assigned

Nov 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2021 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Shenan Bradshaw DDS MD PA

  dba Piedmont Oral and Maxillofacial Surgery

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Greensboro, NC
  • NPI 1114710472
  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491782400000",
    "number": "1659444776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 PARKWAY",
            "address_2": "SUITE A1",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011661",
            "telephone_number": "336-663-8586",
            "fax_number": "877-710-7903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 PARKWAY",
            "address_2": "SUITE A1",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011661",
            "telephone_number": "336-663-8586",
            "fax_number": "877-710-7903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHORN",
        "first_name": "DAVID",
        "middle_name": "JASON",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2017-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NC",
            "license": "6366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8990074",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shahid Ahmed Mohammed, MD
• Riann Mohar
• Dorina Louise Mohite, LP
• Mohorn & Associates DDS PLLC (Mohorn Oral Surgery & Implant Center)
• Mohorn, Belcher & Gollehon, DDS. PA
• Harold W Mohorn, DDS, MS
• Steven G Mohorn, DDS, MS
• Tyler Matthias Mohr, PA-C
• Kimberly Moles
• Domonique Momon

• Oral & Maxillofacial Surgery (D.M.D.) in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.