Sina Mousavi

Primary specialty

DentistTaxonomy code 122300000X

License

0401418368 Issued in VA

Practice address

1175 Mount Hood Ave
Woodburn, OR 97071-9060

Phone

(503) 982-2000

Fax

(503) 982-0660

NPI assigned

Sep 28, 2018

Last updated

Oct 20, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: smousavi35093@yvfwc.direct-ci.com

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

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1851876478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13625 OFFICE PL STE 102",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924270",
            "telephone_number": "571-470-7239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 MOUNT HOOD AVE",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "970719060",
            "telephone_number": "503-982-2000",
            "fax_number": "503-982-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSAVI",
        "first_name": "SINA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-28",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D11398",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60882838",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401418368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabel Morales-Gonzales
• Karina Morales-Ornelas
• Angeles Santos Morales
• Lloyd Tetsuo Morita, MD
• Megan Elizabeth Morse, RN
• Mark Mullenbach, DMD
• Patra J Murdock, NP
• Janet A Murphy, SPEEH THERAPIST
• National Vision, Inc.
• Emilee Nehring

• Dentist in Woodburn, OR
• Providers in Woodburn, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.