Mehran Hossainizadeh, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DA030545R Issued in PA

Practice address

3223 N. Broad Street
Philadelphia, PA 19140

Phone

(215) 707-7756

Fax

(215) 707-5885

NPI assigned

Apr 26, 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

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Temple University of the Commonwealth System of Higher Education

  • Podiatrist
  • Philadelphia, PA
  • NPI 1265446983
  Medicare reassignment NPD
• Temple University of the Commonwealth System of Higher Education

  • Oral and Maxillofacial Surgery (Dentist)
  • Philadelphia, PA
  • NPI 1912687187
  Medicare reassignment
• Dr Michael Ryan PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Upland, PA
  • NPI 1437104080
  NPD (past)
• Temple University of the Commonwealth System of Higher Education

  • Dental Clinic/Center
  • Philadelphia, PA
  • NPI 1841268604
  NPD (past)

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1699732602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 824635",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191824635",
            "telephone_number": "215-707-2912",
            "fax_number": "215-707-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 N. BROAD STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19140",
            "telephone_number": "215-707-7756",
            "fax_number": "215-707-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSSAINIZADEH",
        "first_name": "MEHRAN",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "53369",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DA030545R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hospital of the University of Pennsylvania Pharmacy
• Hospital University of Pennsylvania
• Hospitality House Outpatient Services
• Muhaiminu Hossain, D.P.M.
• Nasheed Mohammad Hossain, M.D.
• Golkoo Sadat Hosseini, MD
• Mahdie Hosseini
• Zachary Michael Hostetler, MD
• Amy L Hostetter, LCSW
• Katherine Hostetter

• Oral and Maxillofacial Surgery (Dentist) in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.