Mohammad Reza Movahedi

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

61566970 Issued in WA

Practice address

903 40TH Ave SW Ste 200
Puyallup, WA 98373-6506

Phone

(253) 435-5656

NPI assigned

May 22, 2024

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

Practice roles

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.

• Unlv Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Las Vegas, NV
  • NPI 1558764456
  NPD (past)

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

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1811736663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 SHADOW LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 40TH AVE SW STE 200",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983736506",
            "telephone_number": "253-435-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOVAHEDI",
        "first_name": "MOHAMMAD REZA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-22",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "61566970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tatiana Motschman, DNP
• Darren Mott, PT
• Marila Moul, WHNP
• Mountain View Massage & Bodywork
• Ross Allan Moutier, MA
• Nagini Movva
• Kimberly Lynn Mowery-Reams, LMT
• Mt. Rainier Emergency Physicians, PLLC
• Peter Mwaura Muchai
• Suraj Reddy Muddasani, MD

• General Practice Dentistry in Puyallup, WA
• Providers in Puyallup, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; 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.