| NPI | 1174074199 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2016-10-14 |
| Last Updated | 2025-08-25 |
| Mailing Address | 1620 S Harbor Blvd Fullerton, CA 92832-3473 United States Phone: (213) 222-5183 📍 View Map |
| Primary Practice Address | 1620 S Harbor Blvd Fullerton, CA 92832-3473 United States Phone: (714) 294-7070 📍 View Map |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 1223S0112X – Dentist, Oral and Maxillofacial Surgery | CA | 107536 |
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About NPI 1174074199
Sean Moghadam is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1174074199. The primary specialty listed is Dentist, Oral and Maxillofacial Surgery. The provider is located in Fullerton, CA. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2016-10-14. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1174074199?
NPI 1174074199 belongs to Sean Moghadam, a Dentist, Oral and Maxillofacial Surgery in Fullerton, CA. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1174074199 active?
The current status of NPI 1174074199 in the NPPES registry is Active. The record was last updated on 2025-08-25.
What specialty is NPI 1174074199?
NPI 1174074199 is classified under the taxonomy Dentist, Oral and Maxillofacial Surgery. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1174074199?
You can verify NPI 1174074199 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1174074199?
The primary practice address on file for NPI 1174074199 is 1620 S Harbor Blvd, Fullerton, CA 92832-3473. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1174074199 issued?
NPI 1174074199 was first issued (enumerated) on 2016-10-14. The NPPES record was last updated on 2025-08-25.
Practice Location Map
Sean Moghadam is located at 1620 S Harbor Blvd, Fullerton, CA. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Sean Moghadam. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1174074199. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Dentist, Oral and Maxillofacial Surgery | 107536 | CA |