Individual provider Active NPI

Vijay Anthony Mohamed, DDS

  • General Practice Dentistry
  • Colton, CA
National Provider Identifier
1750952800
Registry record updated Feb 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
112126 Issued in CA
Practice address
944 Via Lata
Colton, CA 92324-3918
Phone
(615) 946-8805
NPI assigned
Jul 8, 2021
Last updated
Feb 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 112126 CA Primary
General Practice Dentistry 1223G0001X 11756 TN

Addresses

Primary practice location

944 Via Lata
Colton, CA 92324-3918

Mailing address

944 Via Lata
Colton, CA 92324-3918
Phone (615) 946-8805

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20220301001342 TN Order and Referring Only - DentistPractitioner - Dentist 9133513526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
112126CAMDGeneral Practice Dentistry
11756TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Good Times Dental, Professional Corporation General Practice Current Accepting new patients
Hampton Roads Family Dental Portmouth LLC General Practice CurrentSince Jul 17, 2021 Accepting new patients

Locations

944 Via Lata
Colton, CA 92324
Phone (909) 340-9100

3219 Stamford Rd
Portsmouth, VA 23703
Phone (757) 484-1202

Organizations & group practices 2

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": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771027200000",
    "number": "1750952800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "944 VIA LATA",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923243918",
            "telephone_number": "615-946-8805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "944 VIA LATA",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923243918",
            "telephone_number": "615-946-8805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMED",
        "first_name": "VIJAY",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-08",
        "last_updated": "2026-02-14",
        "certification_date": "2026-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "112126",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "11756",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.