NPIMap

Individual provider Active NPI

Mohammad Reza Shefaat, D.D.S.

  • General Practice Dentistry
  • North Bethesda, MD
National Provider Identifier
1922036516
Registry record updated Nov 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13831 Issued in MD
Practice address
6000 Executive Blvd
North Bethesda, MD 20852-3803
Phone
(301) 365-0055
Fax
(301) 365-0056
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2016

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 13831 MD Primary

Addresses

Primary practice location

6000 Executive Blvd
North Bethesda, MD 20852-3803

Mailing address

9802 Raleigh Tavern CT
Bethesda, MD 20814-2129
Phone (301) 365-0055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University General Practice Past Accepting new patients
Chadha & Co Dental-Rockville, LLC General Practice PastSince Nov 9, 2025 Accepting new patients

Organizations & group practices 2

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1922036516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9802 RALEIGH TAVERN CT",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208142129",
            "telephone_number": "301-365-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 EXECUTIVE BLVD",
            "city": "NORTH BETHESDA",
            "state": "MD",
            "postal_code": "208523803",
            "telephone_number": "301-365-0055",
            "fax_number": "301-365-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEFAAT",
        "first_name": "MOHAMMAD",
        "middle_name": "REZA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "13831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; 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.