Healthcare Provider Details

I. General information

NPI: 1538099635
Provider Name (Legal Business Name): MOHAMMED HARB DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 ELM ST
NEW HAVEN CT
06511-4549
US

IV. Provider business mailing address

144 BOSTON AVE
BRIDGEPORT CT
06610-1604
US

V. Phone/Fax

Practice location:
  • Phone: 475-242-0503
  • Fax:
Mailing address:
  • Phone: 475-242-0503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14805
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: