Nida Moledina

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN122842 Issued in GA

Practice address

171 Gwinnett Dr Ste C
Lawrenceville, GA 30046-5686

Phone

(770) 963-1941

NPI assigned

Jun 7, 2022

Sex

Female

Sole proprietor

No

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

Enrolled in GA

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

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Moores Mill Modern Dentistry, PC

  • Dentist
  • Atlanta, GA
  • NPI 1942871439
  NPD (past)

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1912636820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 STANLEY PARK DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300334429",
            "telephone_number": "404-643-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 GWINNETT DR STE C",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300465686",
            "telephone_number": "770-963-1941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1775 Clairmont Rd",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300334005",
            "country_code": "US",
            "telephone_number": "404-325-5440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLEDINA",
        "first_name": "NIDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN122842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrian Mark Mogos, MD
• Heval Mohamed Kelli, M.D.
• Halima Mohamed, NP
• Mustafa Mohammed Salih, MD
• Amber Yvonne Mohn
• Amanda Moliterno
• Suzanne Molock, MD
• Fatema Momin
• Hira Asif Momin
• Lubna Rizvan Momin

• General Practice Dentistry in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.