Mo Taheri, D.M.D., Inc.

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

63463 Issued in CA

Legal business name

MO TAHERI, D.M.D., INC.

Practice address

1640 Newport Blvd
Suite 300
Costa Mesa, CA 92627-3786

Phone

(949) 200-3150

NPI assigned

Oct 26, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Mohammad Taheri, D.M.D.

Title

President

Phone

(949) 200-3150

Specialties & licenses 1

Addresses

Other names 1

• Vivid Smiles Doing business as

Locations

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

{
    "created_epoch": "1414281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414281600000",
    "number": "1750786349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 NEWPORT BLVD",
            "address_2": "SUITE 300",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273786",
            "telephone_number": "949-200-3150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 NEWPORT BLVD",
            "address_2": "SUITE 300",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273786",
            "telephone_number": "949-200-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MO TAHERI, D.M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-26",
        "last_updated": "2014-10-26",
        "status": "A",
        "authorized_official_last_name": "TAHERI",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-200-3150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "63463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vivid Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Prosthodontics in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Prosthodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2014; 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.