DR. FARDAD MOBED (NPI# 1912027293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912027293 |
| Entity Type | Individual |
| Full Name | DR. FARDAD MOBED |
| Credential | D.M.D. |
| Practice Address |
603 Broadway Revere MA 02151-3045 |
| Mailing Address |
14 Webb Ave Wellesley MA 02481-5431 |
| Practice Telephone | 7812893600 |
| Mailing Telephone | 7812893600 |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2008-06-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223D0001X |
Dentist Specialization: Dental Public Health |
18187 | MA | Dental Providers |
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
18187 | MA | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
18187 | MA | Dental Providers |
| Street Address |
603 BROADWAY |
| City | REVERE |
| State | MA |
| Zip Code | 02151-3045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568604114 | Lily Parsi | Dentist | 603 Broadway, Revere, MA 02151-3045 | 2009-03-28 |
| 1912166141 | Dr. Fardad Mobed, P.C. | Dentist | 603 Broadway, Revere, MA 02151-3045 | 2008-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558853580 | Carla Richman | Behavioral Analyst | 29 Arnold Street, Revere, MA 02151 | 2018-06-05 |
| 1558859850 | Citizens Physical Therapy Inc | Clinic/Center | 221 Beach St, Revere, MA 02151 | 2018-04-23 |
| 1396254892 | Holness Home Care | Home Health | 959 Revere Beach Parkway, Revere, MA 02151 | 2017-09-27 |
| 1841709938 | Stefanie Finocchio-durham | Acupuncturist | 107 Pearl Ave, Apt 3, Revere, MA 02151 | 2017-09-21 |
| 1174064265 | Hope Noelle Crowe | Behavioral Analyst | 164 Winthrop Parkway, Revere, MA 02151 | 2017-03-09 |
| 1033660469 | Driss Bahraoui | Interpreter | 21 Thornton St #1, Revere, MA 02151 | 2016-10-20 |
| 1568910081 | Lindsey J. Ellermeyer | Student in an Organized Health Care Education/Training Program | Revere Community Counseling, 265 Beach Street, Revere, MA 02151 | 2016-09-13 |
| 1851743470 | Jacqueline Galvez | Counselor | 252 Proctor Ave # 3, Revere, MA 02151 | 2016-07-07 |
| 1518321090 | Kathleen Elizabeth Pellecchia | Health Educator | 454 Broadway Fl 3, Revere, MA 02151 | 2016-04-11 |
| 1780098814 | David A Gross | Internal Medicine | Mgh Revere, 385 Broadway, Revere, MA 02151 | 2014-06-17 |
| Find all providers in zip 02151 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154415362 | Elina Fooks | Dentist | 50 Squire Rd, Revere, MA 02151-1314 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508464603 | Thabet Housami | Dentist | 635 Albany Street G-201, Boston, MA 02118-2392 | 2020-10-12 |
| 1255954178 | Citidental Brookline Pllc | Dentist | 637 Washington St Ste 210, Brookline, MA 02446-4579 | 2020-05-27 |
| 1972135028 | Endodontic Center, P.C. | Dentist | 1256 Park St Ste 203, Stoughton, MA 02072-3745 | 2020-02-06 |
| 1497228498 | Westwood Dental Associates, LLC | Dentist | 541 High St Ste 3, Westwood, MA 02090-1628 | 2019-01-02 |
| 1720561459 | Omar Alkhattab | Dentist | 72 E Concord St Rm 318, Boston, MA 02118-2307 | 2018-09-10 |
| 1851892434 | Anne Lauren Koch | Dentist | 29 Lewis Bay Blvd, Suite 4, West Yarmouth, MA 02673 | 2018-02-28 |
| 1912407560 | Endodontic Care of Ma, P.C. | Dentist | 151 E Central St, Franklin, MA 02038-1439 | 2018-02-20 |
| 1366940389 | Glick & Ritch Endo North Andover PC | Dentist | 140 Willow St # 2, North Andover, MA 01845-5918 | 2018-01-24 |
| 1295251007 | Iona Dental, P.C. (parent Organization) | Dentist | 10 Granite Street, Unit - 4c, Quincy, MA 02169 | 2017-08-15 |
| 1588198667 | Rafael Carmona | Dentist | 1290 Tremont St Fl 2, Roxbury, MA 02120-3432 | 2017-04-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.