Individual provider Active NPI

Ghina Morad, DMD

  • Dentist
  • Redwood City, CA
National Provider Identifier
1659774123
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
49149 Issued in CA
Practice address
2920 Broadway
Redwood City, CA 94062-1578
Phone
(650) 592-6396
Fax
(650) 592-6241
NPI assigned
Sep 29, 2014
Last updated
Apr 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 49149 CA Primary

Addresses

Primary practice location

2920 Broadway
Redwood City, CA 94062-1578

Mailing address

12 Woodhill Dr
Redwood City, CA 94061-1827
Phone (650) 996-4685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150808015839 CA Order and Referring Only - DentistPractitioner - Dentist 5991019648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
49149CAMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ghina Morad, DMD, a Professional Corporation CurrentSince Jan 18, 2005 Accepting new patients

Locations

2920 Broadway
Redwood City, CA 94062
Phone (650) 368-1353

1785 San Carlos Ave
Ste 2B
San Carlos, CA 94070
Phone (650) 549-1964

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1411948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1659774123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 WOODHILL DR",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940611827",
            "telephone_number": "650-996-4685",
            "fax_number": "801-780-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 BROADWAY",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940621578",
            "telephone_number": "650-592-6396",
            "fax_number": "650-592-6241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAD",
        "first_name": "GHINA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-29",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "49149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

Verify at the official NPI Registry.