Ali Modiri, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

009363 Issued in CT

Practice address

44 Strawberry Hill Ave Ste 1
Stamford, CT 06902-2632

Phone

(917) 658-5863

NPI assigned

Nov 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365638400000",
    "number": "1700868973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 STRAWBERRY HILL AVE STE 1",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069022632",
            "telephone_number": "917-658-5863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 STRAWBERRY HILL AVE STE 1",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069022632",
            "telephone_number": "917-658-5863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODIRI",
        "first_name": "ALI",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2013-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "009363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700868973",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002093631",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen B Mizrachi, OT
• Mjar Inc
• MNL Special Education Services LLC
• Mobility Care LLC
• Michael James Moccio, DDS
• Hiren Mody, MD
• Ahmed-Zayn Mohamed, MD
• Shahrzad Mohammadi, MD
• Michael Moi, PA-C
• Altagracia Carmene Moise, MD

• All providers in Stamford, CT
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; 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.