Individual provider Active NPI

Hajra Mujtaba, DMD

  • General Practice Dentistry
  • Corpus Christi, TX
National Provider Identifier
1720554843
Registry record updated Oct 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
34688 Issued in TX
Practice address
4224 Ayers St
Corpus Christi, TX 78415-5317
Phone
(361) 853-8000
NPI assigned
Oct 16, 2018
Last updated
Oct 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 34688 TX Primary

Addresses

Primary practice location

4224 Ayers St
Corpus Christi, TX 78415-5317

Mailing address

5702 Timbergate Dr Apt 608
Corpus Christi, TX 78414-3184
Phone (617) 870-1406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
34688TXMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Easy Breezy Dental PLLC General Practice Current Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1720554843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5702 TIMBERGATE DR APT 608",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784143184",
            "telephone_number": "617-870-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4224 AYERS ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784155317",
            "telephone_number": "361-853-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUJTABA",
        "first_name": "HAJRA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-16",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; 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.