Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1861610842 Deactivated / Inactive NPI Male Practitioner

Dr. Mohammad H Taheri , DMD

Dentist - General Practice • Chicago, IL

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Mohammad Taheri has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 23, 2007
NPI Deactivation Date January 19, 2025
Total Practice Duration ~18 Years of Practice (2007 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Mohammad Taheri, DMD was a registered Dentist - General Practice practicing in Chicago, IL. Throughout an active medical career spanning 18 years, Dr. Taheri provided care at the practice location at 630 W WASHINGTON BLVD until profile deactivation on 2025-01-19.

Practice Location & Contact Primary Location

Practice Address

630 W Washington Blvd

Chicago, IL 606612117

Telephone 3129398550

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Chicago, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 17.5 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
1200 Specialists

Practicing in Chicago, IL (5581 Statewide)

Telehealth Adoption Rate
0.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-02-05
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IL 019.033505

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Dentist - Prosthodontics

NUCC Taxonomy Code: 1223P0700X

State License IL 021.003203

That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Patrick Pierre , DDS

Dentist - Prosthodontics

NPI 1609085414

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
📍
Updated Practice Location February 05, 2025

Registered at 630 W WASHINGTON BLVD, CHICAGO, IL 606612117 (Tel: 3129398550)

📍
Updated Business Mailing Address February 05, 2025

Registered at 630 W WASHINGTON BLVD, CHICAGO, IL 606612117 (Tel: 3129398550)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 05, 2025

Dentist (License #021.003203 in IL)

🔄
NPI Profile Reactivated January 28, 2025

Record officially reactivated for active practice on January 28, 2025

⚠️
NPI Profile Deactivated January 19, 2025

Record deactivated on January 19, 2025

NPI Profile Active October 26, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location October 26, 2014

Registered at 1640 NEWPORT BLVD, SUITE 300, COSTA MESA, CA 926273786 (Tel: 9492003150)

📍
Updated Business Mailing Address October 26, 2014

Registered at 1640 NEWPORT BLVD, SUITE 300, COSTA MESA, CA 926273786 (Tel: 9492003150)

👤
Provider Name / Credentials Updated October 26, 2014

Recorded as MOHAMMAD TAHERI, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 26, 2014

Dentist (License #21620 in MA)

🟢
Initial NPI Registration & Enumeration April 23, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Mohammad Taheri. Be the first to share your experience!

Sign in to leave a review for Dr. Mohammad Taheri

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1861610842
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 23, 2007
Last Update: February 05, 2025
Deactivation Date: January 19, 2025
Sole Proprietor: No

Mailing Address

630 W Washington Blvd

Chicago, IL 606612117

Phone: 3129398550

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.