| NPI | 1174522387 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2005-07-19 |
| Last Updated | 2007-07-08 |
| Mailing Address | 11190 Monument Landing Blvd Jacksonville, FL 32225 United States Phone: (904) 645-9162 | Fax: (904) 998-8812 📍 View Map |
| Primary Practice Address | 11190 Monument Landing Blvd Jacksonville, FL 32225-4580 United States Phone: (904) 645-9162 | Fax: (904) 998-8812 📍 View Map |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 122300000X – Dentist | FL | 11314 |
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About NPI 1174522387
Siamac Mashod DDS is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1174522387. The primary specialty listed is Dentist. The provider is located in Jacksonville, FL. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2005-07-19. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1174522387?
NPI 1174522387 belongs to Siamac Mashod DDS, a Dentist in Jacksonville, FL. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1174522387 active?
The current status of NPI 1174522387 in the NPPES registry is Active. The record was last updated on 2007-07-08.
What specialty is NPI 1174522387?
NPI 1174522387 is classified under the taxonomy Dentist. 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 1174522387?
You can verify NPI 1174522387 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 1174522387?
The primary practice address on file for NPI 1174522387 is 11190 Monument Landing Blvd, Jacksonville, FL 32225-4580. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1174522387 issued?
NPI 1174522387 was first issued (enumerated) on 2005-07-19. The NPPES record was last updated on 2007-07-08.
Practice Location Map
Siamac Mashod is located at 11190 Monument Landing Blvd, Jacksonville, FL. 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 Siamac Mashod. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1174522387. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Dentist | 11314 | FL |