Bradley Andrew Mobeck, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS110246 Issued in CA

Practice address

28901 S Western Ave Ste 135
Rancho Palos Verdes, CA 90275-0824

Phone

(310) 469-9096

NPI assigned

Jul 19, 2024

Sex

Male

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 NV

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

State licenses

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

{
    "created_epoch": "1721347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1932947108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10740 WOODBINE ST APT 210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900345483",
            "telephone_number": "818-433-9314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28901 S WESTERN AVE STE 135",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902750824",
            "telephone_number": "310-469-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBECK",
        "first_name": "BRADLEY",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-19",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS110246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mission Prep Healthcare
• Mission Prep Healthcare
• Mission Prep Healthcare
• Marijane Miyake, OTR
• Morgan Mizell, MA, LMFT
• Majid Molaie, M.D.
• Soumya Moorti
• Thomas Owen Morris III, MD
• Alexander Julien Moskhos, PHARMD
• Richard Muniz

• General Practice Dentistry in Rancho Palos Verdes, CA
• Providers in Rancho Palos Verdes, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.