Mostafa Fakhrzadeh, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI01667500 Issued in NJ

Practice address

153 Broad St
Flemington Mall Family and Cosmetic Dental Group
Flemington, NJ 08822-1629

Phone

(908) 782-9790

NPI assigned

May 23, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790995165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 FRESH PONDS RD",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088162511",
            "telephone_number": "732-422-0749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 BROAD ST",
            "address_2": "FLEMINGTON MALL FAMILY AND COSMETIC DENTAL GROUP",
            "city": "FLEMINGTON",
            "state": "NJ",
            "postal_code": "088221629",
            "telephone_number": "908-782-9790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKHRZADEH",
        "first_name": "MOSTAFA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI01667500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrey Espinoza, MD
• Even Keel Counseling LLC
• Everbrook Counseling, LLC
• Cecilia Ezuduemoih
• Hazem Fahmy, MD
• Lisa F. Falcon, M.D.
• Arielle Beth Falcone, MA, NCC, LPC
• Brian Craig Falk, D.D.S.
• Wendi Lynn Falk, LCSW
• Thomas M Fallon, DC

• General Practice Dentistry in Flemington, NJ
• Providers in Flemington, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.