Reza Movahed, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2013024987 Issued in MO

Practice address

1585 Woodlake Dr Ste 208
Chesterfield, MO 63017-5740

Phone

(314) 878-6725

Fax

(314) 878-6726

NPI assigned

Feb 4, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 23, 2021 through Apr 23, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rmovahed366901@hisp.ehr.sutterhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• R Movahed DMD PC

  dba Movahed OMS

  • Oral and Maxillofacial Surgery (Dentist)
  • Chesterfield, MO
  • NPI 1497411953
  NPD Authorized official
• Reza Movahed DMD, LLC

  dba Mid America Oral Surgery and Implant Center

  • Oral and Maxillofacial Surgery Clinic/Center
  • O'Fallon, IL
  • NPI 1740703842
  NPD Authorized official

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1790923365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 WOODLAKE DR",
            "address_2": "SUITE 208",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-878-6725",
            "fax_number": "314-878-6726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 WOODLAKE DR STE 208",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175740",
            "telephone_number": "314-878-6725",
            "fax_number": "314-878-6726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Admiral Trost Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "IL",
            "postal_code": "622362163",
            "country_code": "US",
            "telephone_number": "618-344-3456",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "624 Pierce Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "IL",
            "postal_code": "622692582",
            "country_code": "US",
            "telephone_number": "618-206-2630",
            "fax_number": "618-206-2631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOVAHED",
        "first_name": "REZA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-04",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "021002639",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "2013024987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "2013024987",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea L Mose, FNP, WHNP
• Maggie Patricia Moss
• Catherine Moughal
• Robin G Mourey, O.T.
• Walaa Mouzayen, RDN
• Andrea K Moyer, M.D.
• Susan K Mozaffari, CRNA
• Desiree Mraz, PHARM D.
• MRI Partners of Chesterfield, LLC.
• Joseph A Muccini Jr., M.D.

• Oral and Maxillofacial Surgery (Dentist) in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.