Fardad Mobed, D.M.D.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

18187 Issued in MA

Practice address

603 Broadway
Revere, MA 02151-3045

Phone

(781) 289-3600

NPI assigned

Mar 30, 2007

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)

Not enrolled

State licenses

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.

• Dr. Fardad Mobed, P.C.

  • Endodontics
  • Revere, MA
  • NPI 1912166141
  NPD (past) Authorized official

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212451200000",
    "number": "1912027293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 WEBB AVE",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024815431",
            "telephone_number": "781-289-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 BROADWAY",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021513045",
            "telephone_number": "781-289-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBED",
        "first_name": "FARDAD",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2008-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "MA",
            "license": "18187",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MA",
            "license": "18187",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "18187",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mih N Rob Transportation LLC
• Lucia H. Milla-Deangelo
• Elaine Elizabeth Millett, OTR/L
• Daniela Mira
• Anna Miretsky, DPT
• Srismitha Modem, DMD
• Kelly Mohan, MSW
• Michael Moll, DDS
• Lisa G. Montanye, LICSW
• Mary E Moore, R.N.

• Endodontics in Revere, MA
• Providers in Revere, MA by specialty
• Endodontics in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; 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.