Active NPI
Mohamed Ezz El-Din Hassan Riad, DDS
- General Practice Dentistry
- Stockton, CA
National Provider Identifier
1952555237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 48362
- Practice address
- 4661 Precissi LN Ste a
Stockton, CA 95207-6206 - Phone
- (209) 478-7221
- NPI assigned
- Nov 12, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 48362 | CA | Primary |
Addresses
Primary practice location
4661 Precissi LN Ste a
Stockton, CA 95207-6206
Mailing address
4813 Crown Bench Cir
Elk Grove, CA 95757-4607
Phone (310) 908-8784
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48362 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Waleed Soliman Dental Corp | Past | Accepting new patients | |
| Kunimoto Dental Corp | General Practice | Past | Accepting new patients |
Interoperability endpoints
- mriad@direct.westerndental.com
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": "1226448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235952000000",
"number": "1952555237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4813 CROWN BENCH CIR",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957574607",
"telephone_number": "310-908-8784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4661 PRECISSI LN STE A",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952076206",
"telephone_number": "209-478-7221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIAD",
"first_name": "MOHAMED",
"middle_name": "EZZ EL-DIN HASSAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-11-12",
"last_updated": "2009-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "48362",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.