Tina Mahmoudi, DDS, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

15533 Issued in MD

Practice address

11810 W Market PL Ste 203
Fulton, MD 20759-2703

Phone

(443) 393-3241

Fax

(443) 393-3246

NPI assigned

Oct 30, 2016

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Paisley Orthodontics LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Fulton, MD
  • NPI 1740902436
  NPD Authorized official

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

{
    "created_epoch": "1477785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1710439328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11810 W. MARKET PL",
            "address_2": "SUITE 203",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207594856",
            "telephone_number": "443-393-3241",
            "fax_number": "443-393-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11810 W MARKET PL STE 203",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592703",
            "telephone_number": "443-393-3241",
            "fax_number": "443-393-3246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "606 Frederick Rd",
            "address_2": "Orthodontic Associates",
            "address_purpose": "LOCATION",
            "city": "Catonsville",
            "state": "MD",
            "postal_code": "212284856",
            "country_code": "US",
            "telephone_number": "410-744-2230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHMOUDI",
        "first_name": "TINA",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-30",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MD",
            "license": "15533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghan Anne Lynch, MD
• Dayana Machado
• Jian Madesen
• Chikerenma Maduka
• Aisha Mahboob
• Huy T Mai
• Mokerrum Fatima Malik, M.D.
• Malika Rasheed PA (Vision Rehab)
• Malta Medical Incorporated
• Alexa Mammen, DPT

• Orthodontics and Dentofacial Orthopedics Dentistry in Fulton, MD
• Providers in Fulton, MD by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.