Individual provider Active NPI

Mohsen Taheri, D.D.S

  • General Practice Dentistry
  • Tampa, FL
National Provider Identifier
1861583916
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN24035 Issued in FL
Practice address
13515 Lake Terrace LN
Tampa, FL 33637-1003
Phone
(813) 972-2000
Fax
(813) 998-8169
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN24035 FL Primary

Addresses

Primary practice location

13515 Lake Terrace LN
Tampa, FL 33637-1003

Mailing address

13515 Lake Terrace LN
Tampa, FL 33637-1003
Phone (813) 972-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151223000542 NY Order and Referring Only - DentistPractitioner - Dentist 5799086302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
043600-1NYMDGeneral Practice Dentistry
043600NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Di Smiles Dental PC PastSince Mar 6, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1861583916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13515 LAKE TERRACE LN",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336371003",
            "telephone_number": "813-972-2000",
            "fax_number": "813-998-8169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13515 LAKE TERRACE LN",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336371003",
            "telephone_number": "813-972-2000",
            "fax_number": "813-998-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAHERI",
        "first_name": "MOHSEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN24035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.