Active NPI
Soulmaz T Tabrizi, DDS
- Dentist
- Bowie, MD
National Provider Identifier
1780917922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 14136
- Practice address
- 3060 Mitchellville Rd
Suite 105
Bowie, MD 20716-1389 - Phone
- (301) 390-1711
- NPI assigned
- Sep 4, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 14136 | MD | Primary |
Addresses
Primary practice location
3060 Mitchellville Rd
Suite 105
Bowie, MD 20716-1389
Mailing address
9701 Fields Rd
Apt Number 2002
Gaithersburg, MD 20878-2706
Phone (240) 888-3490
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: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160614001008 | CA | Order and Referring Only - Dentist | 3173814613 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14136 | MD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380585600000",
"number": "1780917922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9701 FIELDS RD",
"address_2": "APT NUMBER 2002",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208782706",
"telephone_number": "240-888-3490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3060 MITCHELLVILLE RD",
"address_2": "SUITE 105",
"city": "BOWIE",
"state": "MD",
"postal_code": "207161389",
"telephone_number": "301-390-1711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABRIZI",
"first_name": "SOULMAZ",
"middle_name": "T",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-04",
"last_updated": "2013-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "14136",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bowie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; 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.