Abbas Mohammadi, D.D.S., P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

008514 Issued in CT

Legal business name

ABBAS MOHAMMADI, D.D.S., P.C.

Doing business as

Columbia Dental

Practice address

483 W Middle Tpke
Manchester, CT 06040-3863

Phone

(860) 645-0111

Fax

(860) 533-9027

NPI assigned

Jun 18, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Abbas Mohammadi, D.D.S., P.C.NPI 1093756488

Title

Owner/Dentist

Phone

(860) 645-0111

Specialties & licenses 1

Addresses

Other names 1

• Columbia Dental Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Abbas Mohammadi, D.D.S.

  • General Practice Dentistry
  • Manchester, CT
  • NPI 1093756488
  Authorized official Same address or phone

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740225317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 W MIDDLE TPKE",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060403863",
            "telephone_number": "860-645-0111",
            "fax_number": "860-533-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 W MIDDLE TPKE",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060403863",
            "telephone_number": "860-645-0111",
            "fax_number": "860-533-9027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABBAS MOHAMMADI, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOHAMMADI",
        "authorized_official_first_name": "ABBAS",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "860-645-0111",
        "authorized_official_credential": "D.D.S., P.C."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "008514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbia Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Manchester, CT
• Providers in Manchester, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.