DR. MANSOUR MOHEBAN (NPI# 1679632467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679632467 |
| Entity Type | Individual |
| Full Name | DR. MANSOUR MOHEBAN |
| Credential | D.M.D. |
| Practice Address |
154 Main St Northborough MA 01532-1930 |
| Practice Telephone | 5083932522 |
| Practice Fax Number | 5083939782 |
| Mailing Telephone | 5083932522 |
| Mailing Fax Number | 5083939782 |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2008-02-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
11905 | MA | Dental Providers |
| Street Address |
154 MAIN ST |
| City | NORTHBOROUGH |
| State | MA |
| Zip Code | 01532-1930 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760870497 | Northborough Family Dental, PC | Clinic/Center | 154 Main St, Northborough, MA 01532-1930 | 2015-01-05 |
| 1326207796 | M Moheban Dmd PC | Dentist | 154 Main St, Northborough, MA 01532-1930 | 2008-06-02 |
| 1023159019 | Lorraine Peterson | Counselor | 154 Main St, Northborough, MA 01532-1930 | 2007-02-11 |
| 1609809466 | David N Moheban | Dentist | 154 Main St, Northborough, MA 01532-1930 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073152153 | Authentic Wellness Therapy LLC | Clinic/Center | Authentic Wellness Therapy LLC, 300 West Main Street, Building B, Northborough, MA 01532 | 2020-01-06 |
| 1396225819 | Shannon Furgal | Behavior Technician | 359 Whitney St, Northborough, MA 01532 | 2018-08-14 |
| 1487145926 | Jonathan Ye | Dentist | 448 Howard St, Northborough, MA 01532 | 2018-05-21 |
| 1205219441 | Nuch of Massachusetts, LLC | Clinic/Center | 10002 Shops Way, Suite A, Northborough, MA 01532 | 2015-07-07 |
| 1164775243 | Christine B Chapman | Nurse Practitioner | 10002 Shops Way Ste A, Northborough, MA 01532 | 2012-10-26 |
| 1013269927 | Lindsay Brady | Social Worker | 295 Crawford St., Northborough, MA 01532 | 2012-10-03 |
| 1366763047 | Christine Rodriguez | Counselor | 20 Main Street, Northborough, MA 01532 | 2010-06-17 |
| 1417189432 | Deborah Anne Carter | Social Worker | 130 Main St., Bldg. 2 Suite F, Northborough, MA 01532 | 2009-08-10 |
| 1780802561 | Department of Mental Health | Case Management | 40 Institute Rd, Oaks B Bldg, Southbridge - Milford Cm, No Grafton, MA 01532 | 2007-04-24 |
| 1285787747 | Karen Leigh Lilley | Counselor | 21 Southwest Cutoff, Northborough, MA 01532 | 2007-01-19 |
| Find all providers in zip 01532 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871134833 | Supontep Teerakanok | Dentist | Henry Goldman School of Dental Medicine, 635 Albany St, Boston, MA 02118 | 2019-10-01 |
| 1437700218 | Mansour Alasiri | Dentist | 650 Albany St Ste 341, Boston, MA 02118-2518 | 2019-09-24 |
| 1508417338 | Bushra Aljahdali | Dentist | 650 Albany St Fl 3, Boston, MA 02118-2518 | 2019-09-23 |
| 1164077152 | North Shore Smiles LLC | Dentist | 293 Humphrey Str., Swampscott, MA 01907 | 2019-08-06 |
| 1790330298 | Cambridge Periodontics LLC | Dentist | 1692 Massachusetts Ave Ste 3, Cambridge, MA 02138 | 2019-08-02 |
| 1043863533 | Ricardo Lazaro Pascual | Dentist | 1 Kneeland St Dept, Boston, MA 02111-1527 | 2019-07-23 |
| 1568014827 | David B Rosen Dmd | Dentist | 57 Bedford St Ste 110, Lexington, MA 02420-4550 | 2019-07-16 |
| 1396209961 | Gabriel Boustani Dmd PC | Dentist | 822 Boylston St Ste 200, Chestnut Hill, MA 02467-2504 | 2019-01-28 |
| 1568935153 | Periodontology Associates of Concord, Pllc | Dentist | 290 Baker Ave Ste 3, Concord, MA 01742-2189 | 2019-01-07 |
| 1467925057 | Periodontology Associates of Lexington, Pllc | Dentist | 35 Bedford St Ste 20, Lexington, MA 02420-4440 | 2019-01-07 |
| Find all providers with the same taxonomy | ||||
| City | NORTHBOROUGH |
| Zip Code | 01532 |
Please comment or provide details below to improve the information on DR. MANSOUR MOHEBAN.
| 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.