CMS-1500 Box 24J / 33a • NPI
1417634320
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
122300000X (CMS C5)
Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)
Box 32 Service Location & ZIP+4
1865 CORDOVA RD, FORT LAUDERDALE, FL, 33316-2198
✓ 9-Digit EDI 837 ZIP+4 (33316-2198)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1417634320 (MOHAMMAD ABDOLLAHZADEHFARD) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
No
Hospice Referring
✓ Eligible
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1417634320)
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Amoxicillin Amoxicillin | 49 | 47 |
| Hydrocodone-Acetaminophen Hydrocodone/Acetaminophen | 11 | 11 |
| Ibuprofen Ibuprofen | 14 | 14 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1417634320 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | MOHAMMAD ABDOLLAHZADEHFARD |
| Plain-English Specialty | Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) NUCC Code: 122300000X (Dentist) |
| Certifying / Licensing Body | American Dental Association (ADA) / State Board of Dental Examiners |
| Practice Location Address | 1865 CORDOVA RD, FORT LAUDERDALE, FL, 33316-2198 |
| Practice Telephone / Fax | Tel: (954) 947-1458 |
| Administrative Mailing Address | 1 SW 94TH TER, PLANTATION, FL, 33324-2429 |
| Enumeration & Last Sync | Enumerated: 2023-07-03 | CMS Record Updated: 2023-07-31 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
🗺️ Open in Google Maps 🏥 More Providers in FORT LAUDERDALE
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Plain-English Taxonomy & CMS Crosswalk (122300000X)
What Does Taxonomy Code 122300000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 122300000X translates to:
"Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (MOHAMMAD ABDOLLAHZADEHFARD)
Typical CPT / Diagnostic Procedures:- Comprehensive Oral Evaluation, Digital Dental Radiographs & Prophylaxis
- Restorative Composite Fillings, Crowns, Endodontic Root Canal & Extractions
- Amoxicillin, Metronidazole & Clindamycin (Odontogenic Infections)
- Chlorhexidine Gluconate 0.12% Oral Rinse & High-Fluoride Varnish
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
122300000X — DentistPlain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) | State: FL | License: 28385 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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