Sumayra Mairaj Mohiuddin, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401412196 Issued in VA

Practice address

2101 Kings Lynn Rd
Midlothian, VA 23113-7506

Phone

(804) 647-6004

NPI assigned

Jun 23, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308787200000",
    "number": "1699061069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 KINGS LYNN RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231137506",
            "telephone_number": "804-647-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 KINGS LYNN RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231137506",
            "telephone_number": "804-647-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHIUDDIN",
        "first_name": "SUMAYRA",
        "middle_name": "MAIRAJ",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2011-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401412196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicen Wray Mitterer, DPT
• Roy H Mittmann, O.D.
• Laura Carolyn Mixon
• Jennifer J Mixson, MS, LPC
• Lily Rose Mlynarczyk
• Corinne Pleasants Mohler, PHARMD
• Valerie Sue Mohrman, LCSW
• Momentum Counseling and Wellness LLC
• William R Monacell, DDS
• Christin R Monger

• General Practice Dentistry in Midlothian, VA
• Providers in Midlothian, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; 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.

Verify at the official NPI Registry.