Active NPI
Mojgan Ansari
- Dentist
- Puyallup, WA
National Provider Identifier
1689307142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE61198512
- Practice address
- 732 Shaw Rd Ste B
Puyallup, WA 98372-5278 - Phone
- (253) 267-7112
- NPI assigned
- Jul 2, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DE61198512 | WA | Primary |
Addresses
Primary practice location
732 Shaw Rd Ste B
Puyallup, WA 98372-5278
Mailing address
732 Shaw Rd Ste B
Puyallup, WA 98372-5278
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220919002993 | WA | Order and Referring Only - Dentist | 0143605683 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE61198512 | WA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Washington Dental Corporation, PC | Dentist | Current | Accepting new patients |
Locations
732 Shaw Rd
Ste B
Puyallup, WA 98372
Phone (253) 267-7112
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656720000000",
"number": "1689307142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "732 SHAW RD STE B",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983725278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "732 SHAW RD STE B",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983725278",
"telephone_number": "253-267-7112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANSARI",
"first_name": "MOJGAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-02",
"last_updated": "2022-07-02",
"certification_date": "2022-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE61198512",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Puyallup, WA
- Ankle & Foot Specialists of Puget Sound, PS (Ankle & Foot Specialist of Puyallup)
- Ankle & Foot Specialists of Puget Sound, PS (Ankle & Foot Specialists of Puyallup)
- Kathryn Keys Annand, MD
- Fidelis Ronny Ansah
- Hwonnie Ansari-Page
- Judith E Antonucci, BA
- Precious Onyinyechi Anuna
- Anzi Dental Center 3
- Ina Apanasevich, DENTURIST
- Meagan Brianna Aplin, DPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.