Moayad Mardini, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

39923 Issued in TX

Practice address

9601 Katy Fwy Ste 360
Houston, TX 77024-1392

Phone

(203) 527-0021

NPI assigned

Jan 9, 2020

Sex

Male

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 CT

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

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1780224477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9601 KATY FWY STE 360",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770241392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 KATY FWY STE 360",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770241392",
            "telephone_number": "203-527-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARDINI",
        "first_name": "MOAYAD",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-09",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "39923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ana Clarissa Butac Marcus, APRN-CNP, RN
• David E Marcus, MD
• Ellen Marcus
• Kate Marder, LPC, ATR-BC
• Natasha Ann Mardick, LCSW
• Fatima Sachwani Maredia, MSN, APRN, NP-C
• Mustaq K Maredia, MD
• Salim Noorjibhai Maredia, M.D.
• Zikar Amir Maredia, CNIM
• Allison Marek, LCSW

• Periodontics in Houston, TX
• Providers in Houston, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; 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.