Mohamed A. Rezk, DDS,MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

110570 Issued in CA

Practice address

7725 Gateway Unit 3226
Irvine, CA 92618-5842

Phone

(859) 447-6955

NPI assigned

May 19, 2014

Last updated

Oct 31, 2024By 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 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 26, 2020 through Oct 26, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1902217490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7725 GATEWAY UNIT 3226",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926185842",
            "telephone_number": "859-447-6955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7725 GATEWAY UNIT 3226",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926185842",
            "telephone_number": "859-447-6955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2202 N Berkshire Rd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229012761",
            "country_code": "US",
            "telephone_number": "434-528-8885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REZK",
        "first_name": "MOHAMED",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DDS,MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-19",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "9415",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401415627",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "110570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dyllenn Reyez
• Linda Reyna, LCSW
• Anna Reynolds, R.N.
• Kelly Anne Reynolds
• Rebecca Reza
• Sage Rezner
• Jennifer Rhee, DO
• Sommy Rhee, PHARM.D.
• Julianna D. Rhode, P.A.
• Joshua Rhodes

• Periodontics in Irvine, CA
• Providers in Irvine, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.