Iman Aly Mokhles, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12605 Issued in MN

Practice address

97 85TH Ave NW
Coon Rapids, MN 55433-6022

Phone

(763) 225-8448

Fax

(763) 225-8449

NPI assigned

Jul 22, 2008

Sex

Female

Sole proprietor

No

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

Enrolled in MN

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

Practice roles

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.

• Family & Cosmetic Gentle Dentistry, LTD

  • General Practice Dentistry
  • Coon Rapids, MN
  • NPI 1982886859
  NPD (past)

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216684800000",
    "number": "1740445402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S STE 415",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351817",
            "telephone_number": "952-224-9771",
            "fax_number": "952-224-9790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 85TH AVE NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554336022",
            "telephone_number": "763-225-8448",
            "fax_number": "763-225-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOKHLES",
        "first_name": "IMAN",
        "middle_name": "ALY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-22",
        "last_updated": "2008-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idhil Mohamed
• Khalid Abdulmalik Mohamed
• Ramlah Mohamed
• Aliasghar Mohebbi Abivardi, DDS
• William J Mohr, MD
• Linda Mongare
• Monkweh LLC
• Stephen Paul Montry, LADC
• Mia Anne Moore Infante
• Delashae A Moore

• General Practice Dentistry in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.