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Active NPI 1811736663 Individual Practitioner Male Practitioner

Mohammad Reza Movahedi

Dentist - General Practice • Puyallup, WA

Professional Overview & Biography Verified Profile Summary

Mohammad Reza Movahedi is a registered healthcare professional specializing in Dentist - General Practice in Puyallup, WA. Practice services are available at 903 40TH AVE SW STE 200 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

903 40th Ave Sw Ste 200

Puyallup, WA 983736506

Telephone 2534355656
Associated Practice Facility / Clinic
🏢 Mahadeep Virk, Dmd-Puyallup Facility NPI 1013123181

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Puyallup, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.3 Yrs
Regional Practice Density
65 Specialists

Practicing in Puyallup, WA (3345 Statewide)

Telehealth Adoption Rate
0.0% 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: 2026-07-27
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License WA 61566970

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.

Practice Associates & Co-Workers

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

2 Associated Practitioners
Dr. Varun Sharma , DMD

Dentist - General Practice

NPI 1710110085

Doctor of Dental Medicine

Dr. Mahadeep Virk , DMD

Dentist - General Practice

NPI 1730309113

Doctor of Dental Medicine

Career & Practice History Timeline

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

8 Historical Events
📍
Updated Practice Location July 27, 2026

Registered at 903 40TH AVE SW STE 200, PUYALLUP, WA 983736506 (Tel: 2534355656)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 27, 2026

Dentist (License #61566970 in WA)

NPI Profile Active May 22, 2024

NPI status registered as active in NPPES database

📍
Updated Practice Location May 22, 2024

Registered at 1001 SHADOW LN, LAS VEGAS, NV 891064124 (Tel: 7027742400)

📍
Updated Business Mailing Address May 22, 2024

Registered at 1001 SHADOW LN, LAS VEGAS, NV 891064124

👤
Provider Name / Credentials Updated May 22, 2024

Recorded as MOHAMMAD REZA MOVAHEDI

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 22, 2024

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration May 22, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1811736663
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 22, 2024
Last Update: July 27, 2026
Sole Proprietor: Yes

Mailing Address

1001 Shadow Ln

Las Vegas, NV 891064124

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.