Active NPI
Mustafa Adami
- Periodontics
- Redlands, CA
National Provider Identifier
1750739983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 100193
- Practice address
- 107 Jennifer St
Redlands, CA 92373-4957 - Phone
- (909) 388-2427
- NPI assigned
- May 27, 2016
- Last updated
- Apr 10, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 100193 | CA | Primary |
| Dentist | 122300000X | 100193 | CA |
Addresses
Primary practice location
107 Jennifer St
Redlands, CA 92373-4957
Mailing address
107 Jennifer St
Redlands, CA 92373-4957
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170302001447 | CA | Order and Referring Only - Other (Non-Physician) | 6204110687 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100193 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744243200000",
"number": "1750739983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 JENNIFER ST",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923734957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 JENNIFER ST",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923734957",
"telephone_number": "909-388-2427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADAMI",
"first_name": "MUSTAFA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-27",
"last_updated": "2025-04-10",
"certification_date": "2025-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "100193",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "100193",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.