Mohamed A Ganni, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

24769 Issued in TX

Practice address

3302 McFaddin St
Suite 4
Beaumont, TX 77706-5038

Phone

(409) 838-4200

NPI assigned

Sep 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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 Jan 1, 2016 through Jan 1, 2028

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 and National Provider Directory roles.

• R.M.Phillips, D.M.D. and J.R.Laughlin,D.M.D., Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Beaumont, TX
  • NPI 1699003566
  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249603200000",
    "number": "1679679666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3302 MCFADDIN ST",
            "address_2": "SUITE 4",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777065038",
            "telephone_number": "409-838-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 MCFADDIN ST",
            "address_2": "SUITE 4",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777065038",
            "telephone_number": "409-838-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNI",
        "first_name": "MOHAMED",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2009-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "051852",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "24769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hamza Gadit, PHARMD
• Cristina Galati
• Holly Nicole Gallier, M.ED, LPC
• Nency Kashyap Ganatra
• Jonathan Leroy Gandy, O.D.
• Ana Paula Garcia Quintana
• Maurilio Garcia-Maldonado, MD
• Allyce Catalina Garcia, LMT
• Christina Garcia, FNP-C
• Gardenia Thorn Therapeutic Alternatives, PLLC

• Oral and Maxillofacial Surgery (Dentist) in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2009; 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.